糖化血红蛋白联合脑钠肽对老年急性心肌梗死住院患者临床预后的评估价值  

Clinical value of glycated hemoglobin combined with brain natriuretic peptide in predicting the prognosis of elderly hospitalized patients with acute myocardial infarction

作　　者：田丽晓[1] 秦历杰[1] 王龙安[1] 张培荣[1] 贺文奇[1] 任莹[1] 韩涵[1] 李琳[1] Tian Lixiao;Qin Lijie;Wang Longan;Zhang JPeirong;He Wenqi;Ren Ying;Han Han;Li Lin(Depurtment of Emergency Medicine,Henan Provincial People's Hospital,Zhengzhou 450000,China)

机构地区：[1]河南省人民医院急诊内科,郑州450000

出　　处：《中华老年医学杂志》2020年第10期1174-1177,共4页Chinese Journal of Geriatrics

摘　　要：目的探讨糖化血红蛋白(HBA1c)和脑钠肽(BNP)与急性心肌梗死临床预后的关系。方法选取2016年3月至2017年6月在我院行经皮冠状动脉成形术(PCI)治疗的急性心肌梗死且合并糖尿病患者108例。根据患者HbA1c分为3组。A组(HbA1c≤6.9%)36例;B组(7%≤HbA1c≤7.9%)31例;C组(HbA1c≥8%)41例。分析3组患者HbA1c和N末端B型脑钠肽原(NT-pro BNP),入院时和出院时心功能分级情况,住院期间不良心脏事件的发生率,以及入院时、出院时及出院后3个月左心室射血分数(LVEF)。结果 3组患者中,C组血浆NT-proBNP高于B组和A组(均P<0.05)。而B组和C组患者间无明显差异(P<0.05)。进一步分析C组HbA1c水平与NT-proBNP呈直线正相关(P<0.05)。出院时,A组和B组心功能分级情况较佳,而C组心功能分级情况较差。住院期间,C组不良心脏事件发生率为29.3%,高于A组(8.3%)和B组(9.7%)(均P<0.05)。出院时和出院后3个月,A组和B组患者LVEF的水平均较入院时明显改善,C组水平较入院时无明显改善,且C组患者LVEF水平低于A组和B组(均P<0.05)。结论 HbA1c和NT-proBNP可作为急性心肌梗死患者PCI后联合监测指标,以预防和减少急性心肌梗死PCI后的并发症发生率和病死率,改善临床预后。Objective To investigate the relationship of glycated hemoglobin(HbAlc)and brain natriuretic peptide(BNP)level.s with clinical prognosis of acute myocardial infarction.Methods A total of 108 patients with acute myocardial infarction combined with diabetes mellitus,who underwent percutaneous coronary intervention(PCI)from March 2016 to June 2017 in our hospital,were enrolled.According to the HbAlc level.patients were divided into three groups:Group A(HbAlc≤6.9%,n=36),Group B(7%≤HbAlc≤7.9%,n=31)and Group C(HbAlc≥8%,n=41).HbAlc and NT-proBNP levels,cardiac function classification at admission and discharge,the incidence of adverse cardiac events during hospitalization and left ventricular ejection fraction(LVEF)at admission,discharge and 3 months after discharge were analyzed.Results Among the three groups,plasma NT-proBNP levels were higher in Group C than in Group B and Group A(P<O.05),and there was no significant difference between Group B and Group C(P<C 0.05).Furthermore.HbAlc levels were positively correlated with NT-proBNP levels in Group C(P< 0.05).Cardiac function grading was better in Group A and Group B than in Group C at discharge.During hospitalization,the incidence of adverse cardiac events in Group C was 29.3%,which was higher than in Group A(8.3%)and Group B(9.7%)(P<0.05).LVEF levels were significantly improved in Group A and Group B at discharge and 3 months after discharge^compared with those at admission,while Group C had no significant improvement in LVEF levels and had lower LVEF than Group A and Group B(P<0.05).Conclusions HbAlc and NT proBNP levels can be used as a joint monitoring indicator in patients with acute myocardial infarctions after PCI.to help prevent and reduce the incidence of complications and mortality in patients with acute myocardial infarction after PCI and improve clinical prognosis.

关 键 词：糖化血红蛋白 利钠肽 脑 心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病]