高血糖对冠心病支架植入术后远期左室舒张功能改善的影响  

Impact of hyperglycemia on left ventricular diastolic function in patients with coronary heart disease after stent implanatation

作　　者：吴凤霞[1,2] 徐顺霖[1] 冯新恒[1] 毛节明[1] 

机构地区：[1]北京大学第三医院,北京100191 [2]黑龙江省铁力林业医院

出　　处：《山东医药》2010年第20期12-14,共3页Shandong Medical Journal

摘　　要：目的探讨血糖控制对冠状动脉内支架植入术后左室舒张功能恢复的影响,评价病情及预后转归。方法126例冠心病患者以糖化血红蛋白（HbA1 c）筛选分为血糖异常（B组）与血糖控制良好者（A组）。应用多普勒超声心动图检测二尖瓣血流、舒张早期最大流速（E）、舒张晚期最大流速（A）、E/A比值、舒张早期快速充盈减速时间（DT）,用组织多普勒成像技术（TD I）测量二尖瓣前后叶瓣环运动的舒张早期运动速度（Em）。结果A组DT术后3、6个月均较术后24 h内减少,E/A值、Em在术后24 h内、3、6个月3组间均有显著性改变（P〈0.01）;B组DT仅术后6个月较术后24 h内相比有显著性改变（P〈0.05）,E/A值术后3、6个月较术后24 h内改善,但术后3~6个月没有改善,Em无改善。结论支架植入术后,血糖控制不佳的患者左室舒张功能远期没有改善,提示对于冠心病患者血糖控制的重要性不容忽视。Objective To evaluate the impact of hyperglycemia on left ventricular diastolic function in the patients with coronary heart disease（CHD） after stent implanatation.Methods A total of 126 CAD patients with diabetes mellitus were collected after stent implantation,who were classified by HbA1c,Left ventricular diastolic function of CAD patients with hyperglycemia（group A） had been compared with that of normal blood sugar under control group（group B）.The mitral inflow profile（E,A,E/A） and the deceleration time（DT） were measured,the early-diastolic（Em） peak velocities of the septal mitral annulus was measured by the Dopper tissue image（TDI）.Results In group A,DT decreased significantly after three months and six months.Em and the value of E/A ratio changed significantly within twenty hours,three months and six months（P0.01）.In group B,DT showed significant differences after six months（P0.05）.The value of E/A ratio improved after three months and six months of stent implatation,but did not change between three and six months.Em did not improved significantly.Conclusions Left ventricular diastolic function did not improve in those patients with poor blood sugar control long-term after stent implantation.The importance of hyperglycemia control in patients with CAD should be laid emphasis on.

关 键 词：血糖 冠状动脉疾病 支架植入术 心室舒张功能 

分 类 号：R541.4[医药卫生—心血管疾病]