糖化血红蛋白水平对冠心病患者冠脉旁路移植术早期预后的影响  

Effect of HbA1c on the early prognosis of patients with coronary heart disease after coronary artery bypass surgery

作　　者：石宇[1] 刘学刚[1] 王领 施超[1] 刘戈[1] 孟金金[1] 刁文杰 常明明 王鹏[1] SHI Yu(Department of cardic surgery,The First Affiliated Hospital of Bengbu Medical College,Bengbu 233004,China)

机构地区：[1]蚌埠医学院第一附属医院心脏外科,安徽蚌埠233004

出　　处：《牡丹江医学院学报》2020年第1期58-60,共3页Journal of Mudanjiang Medical University

基　　金：安徽省科技攻关项目(1804h08020290)。

摘　　要：目的探讨体外循环下行冠状动脉旁路移植术的患者术前糖化血红蛋白(HbA1c)水平与术后近期预后的关系。方法180例行冠脉旁路移植手术的冠心病患者根据HbA1c水平分为A组(HbA1c<6.5%,88例)和B组(HbA1c≥6.5%,92例),比较两组患者的炎性指标(C-反应蛋白)、术后6个月后心血管不良反应事件发生率、术后的总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白水平。结果A组患者C-反应蛋白水平低于B组,差异具有统计学意义(P<0.05);A组患者术后第6个月的总胆固醇、甘油三酯、低密度脂蛋白低于B组,高密度脂蛋白水平高于B组,差异均具有统计学意义(P<0.05)。B组患者术后6个月心血管不良反应事件发生的比例高于A组,差异均具有统计学意义(P<0.05)。结论糖化血红蛋白水平不同的冠心病患者在冠脉旁路移植术后早期体内炎性反应、脂质代谢及心血管不良事件发生率存在差异。Objective To evaluate the effect of preoperative glycated hemoglobin(HbA1c)level on short-term outcome in patients with diabetes mellitus undergoing on-pump coronary bypass.Methods 180 patients with coronary artery disease after coronary artery bypass surgery were divided into two groups according to HbA1c level,namely group A(HbA1c<6.5%,88 cases)and group B(HbA1c≥6.5%,92 cases).The inflammatory indexe(CRP)of the two groups were compared.The rate of incidence of cardiovascular adverse events as observed six months after surgery and the levels of total cholesterol,triglycerides,low density lipoprotein and high density lipoprotein of the two groups after operation were compared.Results The levels of CRP of group A were lower than those of group B(P<0.05).The levels of total cholesterol,triglycerides and low density lipoprotein of group A observed six months after operation were lower than those of group B(P<0.05).The levels of high density lipoprotein was higher than those of group B(P<0.05).The rates of incidence of cardiovascular adverse events occurrence to group B observed six months after operation were higher than those of group A(P<0.05).Conclusion There were differences in inflammatory response and lipid metabolism in patients with coronary heart disease with different HbA1c levels in the early stage after coronary artery bypass grafting,as well as differences in the rates of incidence of cardiovascular adverse events.

关 键 词：糖化血红蛋白 冠心病 冠状动脉旁路移植术 

分 类 号：R541.4[医药卫生—心血管疾病]