糖化血红蛋白变异性与2型糖尿病患者PCI术后支架内再狭窄的相关性分析  

Correlation between glycosylated hemoglobin variability and in-stent restenosis after PCI in patients with type 2diabetes

作　　者：张斌[1] 张亚豪 郑绪伟[1] 申泱泱[1] 陈魁[1] ZHANG Bin;ZHANG Yahao;ZHENG Xuwei;SHEN Yangyang;CHEN Kui(Department of Cardiology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450002,China)

机构地区：[1]郑州大学第一附属医院心血管内科,郑州450002

出　　处：《临床心血管病杂志》2022年第3期186-191,共6页Journal of Clinical Cardiology

摘　　要：目的:探讨2型糖尿病患者糖化血红蛋白(HbA1c)变异性与经皮冠状动脉(冠脉)介入治疗(PCI)术后支架内再狭窄(ISR)的关系。方法:连续纳入2017年9月—2021年3月在郑州大学第一附属医院心内科行PCI术的326例2型糖尿病患者。根据术后6个月至1年随访的冠脉造影结果分为ISR组和非ISR组。HbA1c变异性以HbA1c测量值的标准差、变异系数和校正后的标准差表示。建立多因素Cox回归模型分析HbA1c变异性与ISR的关系。结果:基线分析表明,两组在胱抑素C、术前HbA1c、平均HbA1c、钙通道阻滞剂、口服降糖药、胰岛素应用、饮酒状态、脑卒中史、支架数量等方面存在差异(均P<0.05)。在多因素分析中,依次校正多个混杂因素后发现高HbA1c变异性与发生ISR的风险增加独立相关,HR(每1-SD增加)分别为1.73(95%CI:1.14~2.62)、1.77(95%CI:1.17~2.68)、1.73(95%CI:1.14~2.61)。结论:高HbA1c变异性与2型糖尿病患者PCI术后发生ISR的风险增加独立相关。Objective:To investigate the association between glycated hemoglobin(HbA1c)variability and instent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with type 2diabetes.Methods:A total of 326patients with type 2diabetes who underwent PCI were continuously screened from September 2017to March 2021,in the Department of Cardiology,the First Affiliated Hospital of Zhengzhou University.They were divided into ISR group and non-ISR group based on results of follow-up 6months to 1year after coronary angiography.Multivariable Cox models were established to analyze the association between ISR and HbA1cvariability,expressed as standard deviation,coefficient of variation,and adjusted-standard deviation.Results:Baseline analysis showed differences in cystatin C,preoperative HbA1c,mean HbA1c,calcium channel blockers,oral hypoglycemic agent,insulin use,drinking status,history of stroke,and numbers of stents.Multivariate analysis showed that increased HbA1cvariability was independently associated with higher risk of ISR.HR(per 1-SD)was 1.73(95%CI:1.14-2.62),1.77(95%CI:1.17-2.68),1.73(95%CI:1.14-2.61).Conclusion:Increased HbA1cvariability is independently associated with higher risk of ISR after coronary stent implantation in type 2diabetic patients.

关 键 词：2型糖尿病 糖化血红蛋白变异性 支架内再狭窄 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]