糖化血红蛋白对冠心病老年患者PCI手术预后的影响  

Effect of HbA1c on the prognosis of elderly patients with coronary heart disease after percutaneous coronary intervention

作　　者：张步荣[1] 卢帅军 孙一奎[1] ZHANG Bu-rong;LU Shuai-jun;SUN Yi-kui(Clinical Laboratory, The Affiliate Hospital of Ningbo University School of Medicine, Ningbo 315020, China)

机构地区：[1]宁波大学医学院附属医院检验科,浙江宁波315020

出　　处：《健康研究》2019年第1期92-94,97,共4页Health Research

摘　　要：目的探究糖化血红蛋白(Hb A1c)对冠心病老年患者经皮冠状动脉介入治疗(percutaneous coronary interven-tion,PCI)手术预后的影响。方法 220例行PCI手术的冠心病老年患者根据Hb A1c水平分为A组(Hb A1c <6. 5%,112例)和B组(Hb A1c≥6. 5%,108例);比较两组患者的炎性指标(血沉、C-反应蛋白、肿瘤坏死因子、白细胞介素-6),术后3个月和6个月后心血管不良反应事件发生率,术后的空腹血糖、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、尿酸水平。结果 A组患者CRP和TNF-α水平低于B组,差异具有统计学意义(P<0. 05); B组患者术后3个月和术后6个月发生心梗、血管再狭窄发生的比例均高于A组,差异均具有统计学意义(P<0. 05); A组患者术后的空腹血糖和尿酸水平低于B组,差异均具有统计学意义(P<0. 05);患者Hb A1c与CRP、TNF-α、MACE发生率均具有正相关(r_1=0. 583,P_1=0. 004; r_2=0. 341,P_2=0. 003; r_3=1. 326,P_3=0. 029)。结论冠心病老年患者的糖化血红蛋白水平与PCI术后的MACE发生率有关,与患者体内炎症的严重程度有关。Objective To evaluate the effect of HbA1c on the prognosis of elderly patients with coronary heart disease after percutaneous coronary intervention (PCI). Methods 220 elderly patients with coronary artery disease after PCI were divided into two groups according to HbA1c level, namely group A (HbA1c<6.5%, 112 cases) and group B (HbA1c≥6.5%, 108 cases). The inflammatory indexes (erythrocyte sedimentation rate, CRP, TNF-α, IL-6) of the two groups were compared. The rate of incidence of cardiovascular adverse events as observed three months and six months after surgery and the levels of fasting blood glucose, total cholesterol, triglycerides, low density lipoprotein, high density lipoprotein, and uric acid of the two groups after operation were also compared. Results The levels of CRP and TNF-α of group A were lower than those of group B ( P <0.05). The rates of both myocardial infarction occurrence and vascular restenosis occurrence to group B observed three months and six months after operation were higher than those of group A ( P <0.05). The fasting blood glucose and uric acid levels of group A were lower than those of group B ( P <0.05). The HbA1c of patients was positively correlated to CRP, TNF-α and the incidence of MACE( r 1 =0.583, P 1 =0.004;r 2 =0.341, P 2 =0.003;r 3 =1.326, P 3 =0.029). Conclusions The HbA1c level in elderly patients with coronary heart disease is related to the incidence of MACE after PCI and the severity of inflammation in patients.

关 键 词：糖化血红蛋白 冠心病 老年 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]