急性冠脉综合征合并糖代谢异常病人冠脉微循环抵抗指数的研究  

Study on the index of microcirculatory resistance in patients with acute coronary syndrome combined with glycometabolic disturbance

作　　者：蒋建东[1] 赵祥海[1] 杨松[1] 叶飞[2] 陈燕春[1] 

机构地区：[1]宜兴市人民医院心内科,江苏省无锡市214200 [2]南京市第一医院心血管内科,江苏省南京市210006

出　　处：《实用老年医学》2017年第11期1042-1045,共4页Practical Geriatrics

基　　金：无锡市科技局医疗与公众健康技术研发资助项目(CSE31N1434)

摘　　要：目的探讨急性冠脉综合征合并糖代谢异常病人的冠状动脉微循环阻力指数(IMR)。方法分别选择糖代谢异常、糖代谢正常的急性冠脉综合征病人各40例,设为糖代谢正常组和糖代谢异常组。所有病例均行75 g葡萄糖耐量试验,测定空腹血糖(FBG)、餐后2小时血糖(PBG)、空腹胰岛素(FINS)、餐后2小时胰岛素(PINS)、糖化血红蛋白(Hb A1c)、高敏C反应蛋白(hs-CRP)、血脂等指标,同时检测冠状动脉病变靶血管的冠脉血流储备分数(FFR)、IMR并比较。结果糖代谢异常组hs-CRP、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)等生化指标显著高于糖代谢正常组(P<0.05);糖代谢异常组的病变冠状动脉IMR值明显高于糖代谢正常组(P<0.01),2组病变冠状动脉靶血管FFR差异无统计学意义。结论与糖代谢正常的急性冠脉综合征病人比较,糖代谢异常病人冠状动脉微循环障碍更为常见,压力导丝进行IMR测定能较准确反映急性冠脉综合征合并糖代谢异常病人冠状动脉微循环的状态。Objective To explore the index of microcirculatory resistance（ IMR） in patients with acute coronary syndrome complicated with glycometabolic disturbance. Methods A total of 40 patients with glycometabolic disturbance（ group B） and 40 patients with normal glucose tolerance（ group A） were selected. All cases were checked by 75 g glucose tolerance test,and the levels of blood glucose,insulin,Hb A1 c,lipid,hypersensitive C reaction protein（ hs-CRP） and FFR,IMR of tagert coronary artery were measured and compared. Results The levels of hs-CRP,TC,LDL-C in group B were higher than those in group A（ P〈0. 05）. IMR of tagert coronary artery in group B was significantly higher than that in group A（ P〈0. 01）. There was no significant difference between group A and B in FFR. Conclusions Patients with glycometabolic disturbance are likely to suffer from coronary microcirculatory dysfunction.IMR measured by pressure wire can accurately reflect the status of coronary microirculation in patients with acute coronary syndrome combined with glycometabolic disturbance.

关 键 词：急性冠脉综合征 糖代谢异常 微循环障碍 微循环阻力指数 

分 类 号：R541.4[医药卫生—心血管疾病] R587.1[医药卫生—内科学]