糖化血红蛋白及糖化低密度脂蛋白与冠状动脉介入术后心肌灌注的相关性研究  

Association of serum HbAlc and AGE-LDL levels with myocardial perfusion after PCI

作　　者：王成钢[1] 李艳芳[1] 聂绍平[1] 王春梅[1] 阙斌[1] 祖晓麟[1] 

机构地区：[1]首都医科大学附属北京安贞医院急诊危重症中心,100029

出　　处：《中华老年心脑血管病杂志》2015年第7期708-710,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：北京市科委首都临床特色应用研究项目(Z141107002514014);首都医科大学临床基础合作研究项目(13JL88)

摘　　要：目的探讨合并糖尿病的急性心肌梗死患者血清空腹血糖、糖化血红蛋白（HbA1c）及糖化低密度脂蛋白（AGE-IDL）水平与冠状动脉介入治疗（PCI）术后心肌灌注变化的相关性。方法选取首次因急性心肌梗死在我院行急诊PCI合并糖尿病的患者92例,按PCI术后心肌灌注水平（TIMI分级）分为3组,A组61例（TIMI 3级）、B组25例（TIMI 2级）、C组6例（TIMI 0-1级,无复流）,另选取冠状动脉造影阴性患者30例作为对照组（D组）。采用放射免疫法检测血清HbA1c及AGE-LDL水平。比较4组患者血清空腹血糖、HbA1c及AGE-LDL水平与PCI术后心肌灌注的变化及相关性。结果与D组比较,A组空腹血糖水平无显著差异（P〉0.05）,B组和C组空腹血糖[（4.62±1.82）mmo1/L、（5.51±1.73）mmo1/L vs（4.33±1.64）mmol/L]、HbA1c[（2.63±1.23）%、（5.35±1.81）%vs（0.56±0.12）%]和AGE-LDL[（73.80±9.41）μg/L、（95.42±14.56）μg/Lvs（12.46±6.21）μg/L]水平显著升高,A组HbA1c[（0.45±0.16）%vs（0.56±0.12）%]水平降低,差异有统计学意义（P〈0.05）。结论合并糖尿病的急性心肌梗死患者空腹血糖、HbA1c及AGE-LDL水平与直接PCI术后心肌灌注水平呈负相关,空腹血糖、HbA1c及AGE-LDL水平有助于评估PCI术中可能出现的无复流现象。Objective To study the association of serum HbAlc nd AGE-LDL levels with myocardial perfusion in AMI patients with diabetes mellitus（DM） after PCI.Methods Ninety-two AMI patients with DM who underwent PCI in our hospital were divided into group A（n = 61）,group B（n=25）,and group C（n = 6） according to their TIMI.Another 30 persons who were negative for coronary arteriography served as a control group（group D）.Their serum levels of FBG,HbAlc and AGE-LDL were measured by radioimmunoassay.The association of serum HbAlc and AGE-LDL levels with myocardial perfusion was observed in AMI patients with DM after PCI.Results No significant difference was found in serum FBG level between group A and group D（P〉0.05）.The serum levels of FBG,HbAlc and AGE-LDL were significantly hgher in group B than in group C（4.62 ± 1.82 mmol/L vs 4.33 ± 1.64 mmol/L,5.51 ± 1.73 mmol/L vs 4.33 ± 1.64mmol/L;2.63%±1.23%vs 0.56%± 0.12%,5.35%± 1.81%vs 0.56%± 0.12%;73.80 ± 9.41μg/L vs 12.46±6.21 μg/L,95.42 ± 14.56 μg/L vs 12.46 ± 6.21 μg/L;P〈0.05）.The serum HbAlc level was significantly lower in group A than in group B（0.45%±0.16%vs 0.56%± 0.12%,P〈0.05）.Conclusion The serum levels of FBG,HbAlc and AGE-LDL are associated with myocardial perfusion in AMI patients with DM after PCI and help to assess no reflow during PCI.

关 键 词：血红蛋白A 糖基化 脂蛋白类 LDL 心肌再灌注 糖尿病 心肌梗死 血糖 

分 类 号：R542.22[医药卫生—心血管疾病] R587.1[医药卫生—内科学]