入院糖化血红蛋白对接受直接PCI治疗的急性心肌梗死患者心肌灌注及炎性因子的影响  

Influence of glycosylated hemoglobin on myocardial perfusion and inflammation factor in acute myocardial infarction patients complicated with diabetes mellitus receiving primary percutaneous coronary intervention

作　　者：魏辉[1] 李慧[2] WEI Hui LI Hui(Department of Cardiology, The First People＇s Hospital of Tianmen City, Tianmen, Hubei 431700, China Department of Clinical Laboratory, The First People＇s Hospital of Tianmen City, Tianmen, Hubei 431700, China)

机构地区：[1]湖北省天门市第一人民医院心内科,湖北天门431700 [2]湖北省天门市第一人民医院检验科,湖北天门431700

出　　处：《岭南心血管病杂志》2017年第3期266-269,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨合并糖尿病的急性心肌梗死患者糖化血红蛋白(hemoglobin A1c,HbA1c)浓度对直接经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后心肌灌注及炎性指标的影响。方法选取首次因急性心肌梗死合并糖尿病在湖北省天门市第一人民医院行急诊PCI治疗的患者122例,根据患者入院的HbA1c浓度分为2组:A组HbA1c≤6.4%(53例)、B组Hb A1c≥6.5%(69例)。PCI治疗后对心肌灌注水平[心肌梗死溶栓试验(thrombolysis in myocardial infarction,TIMI)分级],和术后1 h、3 d炎性指标,包括白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、超敏C反应蛋白(hypersensitive Creactive protein,hs-CRP)进行分析。结果 A组PCI治疗后TIMI 3级血流比例高于B组,无复流(TIMI 0~1级)比例低于B组,差异有统计学意义(P<0.05)。A组PCI治疗后1 h、3 d,血清IL-6、TNF-α、hs-CRP浓度均低于B组相同时间点时的水平,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,入院时HbAlc浓度影响急诊PCI治疗后心肌灌注情况,HbAlc≥6.5%组患者与HbA1c≤6.4%组患者相比,急诊PCI治疗后心肌灌注情况差,炎性因子水平高。Objectives To investigate the influence of glycosylated hemoglobin on myocardial perfusion and inflammation factors in patients with acute myocardial infarction（MI）complicated with diabetes mellitus receiving percutaneous coronary intervention（PCI）. Methods A total of 122 patients with MI complicated with diabetes mellitus receiving PCI were divided into two groups according to hemoglobin A1c（HbA1c）concentration：A group HbA1c≤6.4%（n=53）,B group Hb A1c≥6.5%（n=69）. Myocardial perfusion and inflammation factor concentrations including interleukin-6（IL-6）,tumor necrosis factor-α（TNF-α）and hypersensitive C-reactive protein（hs-CRP）were monitored 1 hour and 3 days after PCI. Results Myocardial perfusion in A group was higher than that in B group,and the difference was significant（P〈0.05）. Inflammation factor concnetrations 1 hour and 3 days after PCI in A group were lower than those in B group,and the differences were significant（P〈0.05）. Conclusions Glycosylated HbA1c concentration may influence the prognosis of PCI in patients with MI complicated with diabetes mellitus. Patients with HbAlc≥6.5% may result in lower myocardial perfusion and higher inflammation factor than patients with HbA1c≤6.4%,thus may prompt worse prognosis.

关 键 词：心肌梗死 糖化血红蛋白 心肌灌注 炎性因子 

分 类 号：R542.22[医药卫生—心血管疾病]