HbA1c在评估冠心病患者冠脉狭窄严重程度及预测远期预后中的价值  

The value of HbA1c in assessing the severity of coronary stenosis and predicting long-term prognosis in patients with coronary heart disease

作　　者：秦娴[1] 李杏[1] 曹佳宁[1] Qin Xian;Li Xing;Cao Jianing(Department of Cardiology,The Affiliated Wuxi No.2 People's Hospital of Nanjing Medical University,Wuxi 214002,China;不详)

机构地区：[1]南京医科大学附属无锡市第二人民医院心内科,南京214002

出　　处：《中国循证心血管医学杂志》2020年第10期1209-1212,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：江苏省自然科学基金(青年基金项目)(BK20170207)。

摘　　要：目的探讨冠状动脉粥样硬化性心脏病(冠心病)患者糖化血红蛋白(HbA1c)水平与冠状动脉(冠脉)病变程度的关系,评价HbA1c对冠心病患者长期预后的影响。方法纳入2017年9月至2018年4月于南京医科大学附属无锡二院心内科住院的冠心病患者139例,年龄在39~90(68.06±11.21)岁。收集并记录患者基本情况、临床资料等信息,随访12个月,主要终点为院内及随访期间主要不良心脏事件(MACE)。结果运用Pearson相关分析,HbA1c与冠脉病变严重程度具有显著相关性(R=0.4843,P<0.001)。多因素Logistic回归分析提示HbA1c是冠心病患者冠脉病变复杂程度的独立影响因素(P<0.05)。随访12个月,采用log-rank检验对三组无MACE生存率进行比较,A、B、C组MACE发生率随HbA1c值的升高呈上升趋势,三组差异具有显著统计学意义(P=0.000)。结论冠心病患者HbA1c水平与其冠脉病变程度呈显著正相关,HbA1c可作为冠心病的独立危险因素衡量指标,并可预测远期预后。Objective To explore the relationship between HbA1c level and degree of coronary artery disease in patients with coronary heart disease(CHD),and to evaluate the effect of HbA1c on long-term prognosis of patients with CHD.Methods A total of 139 patients aged of 39~90(68.06±11.21)years who were admitted to the Affiliated Wuxi No.2 People’s Hospital of Nanjing Medical University from September 2017 to April 2018 were enrolled in the study.Then we collected and recorded the patient's basic information,clinical data and other information.All patients were followed up for 12 months,with the main end point being major adverse cardiac events(MACE)during in-hospital and follow-up.Results There was a significant correlation between HbA1c and the severity of coronary lesions by using Pearson correlation analysis(y=9.8866x-33.905,R=0.4843,P<0.001).Multivariate logistic regression analysis indicated that HbA1c was an independent factor affecting the complexity of coronary artery disease in patients with coronary heart disease(P<0.05).After 12 months of follow-up,the log-rank test was used to compare the MACE-free survival rates of the three groups.The incidence of MACE in groups A,B,and C showed an upward trend with the increase of HbA1c value,and the difference between the three groups was statistically significant(P=0.000).Conclusion The level of HbA1c in patients with CHD was significantly positively correlated with the degree of coronary artery disease,HbA1c can be used as an independent risk factor for CHD and can predict long-term prognosis.

关 键 词：冠心病 糖化血红蛋白 GENSINI积分 MACE事件 

分 类 号：R541.4[医药卫生—心血管疾病]