非糖尿病STEMI患者直接PCI术后空腹血糖与微血管阻塞的相关性分析  

Association between fasting blood glucose and microvascuar obstruction in nodiabetic patients with ST-elevation myocardial infarction after primary percutaneous coronary intervention

作　　者：俞婷婷[1] 吴韩[2] 王昆[2] YU Tingting;WU Han;WANG Kun(Department of Geriatrics,Affliated Drum Tower Hospital,Medical School of Nanjing University,Nanjing,210008,China;Department of Cardiology,Affliated Drum Tower Hospital,Medical School of Nanjing University,Nanjing,210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院老年科,南京210008 [2]南京大学医学院附属鼓楼医院心内科

出　　处：《临床心血管病杂志》2022年第3期197-201,共5页Journal of Clinical Cardiology

基　　金：国家自然科学基金面上项目(No:81970296)。

摘　　要：目的:评估非糖尿病ST段抬高型心肌梗死(STEMI)患者空腹血糖(FBG)与直接经皮冠状动脉介入治疗(PPCI)术后发生微血管阻塞(MVO)的关系。方法:本研究入组108例非糖尿病STEMI患者,按照心脏磁共振结果分为MVO组及非MVO组。比较两组基础临床资料、实验室资料、介入手术资料、心脏超声及心脏磁共振资料。单因素及多因素logistic回归分析评估MVO的独立影响因子。受试者操作曲线(ROC)曲线评估FBG及联合指标的预测价值。结果:MVO组的FBG明显高于非MVO组。FBG、肌钙蛋白T峰值、左室射血分数及左室舒张末期容积均与MVO独立相关。ROC显示FBG曲线下面积为0.70,FBG>5.47mmol/L预测MVO的灵敏度为0.623,特异度为0.774,联合指标的ROC曲线下面积为0.87。结论:FBG是非糖尿病STEMI患者PPCI术后发生MVO的独立预测因子,联合各个指标预测价值更高。Objective:To evaluate the relationship between fasting blood glucose(FBG)and microvascular occlusion(MVO)after primary percutaneous coronary intervention(PPCI)in nondiabetic patients with ST elevation myocardial infarction(STEMI).Methods:A total of 108nondabetic patients with STEMI were divided into MVO group and non MVO group according to the results of cardiac magnetic resonance.The basic clinical data,laboratory data,interventional surgery data,echocardiography and cardiac magnetic resonance imaging data were compared between the two groups.Univariate regression analysis and multivariate regression analysis were used to evaluate the independent predictors of MVO.Receiver operating characteristic(ROC)curve was used to evaluate the predictive value of FBG and other predictors.Results:FBG of MVO group was significantly higher than that of non MVO group.FBG,peak TnT,LVEF and LVEDV were correlated with MVO independently.The ROC curve showed that the area under the curve of FBG was 0.70,the sensitivity and specificity of FBG>5.47mmol/L in predicting MVO were 0.623and 0.774,respectively.However,the area under the curve of the combination was 0.87.Conclusion:FBG is an independent predictor of MVO after PPCI in nondiabetic STEMI patients.Furthermore,combination of the markers was a strong predictor for MVO after PPCI in nondiabetic STEMI patients.

关 键 词：ST段抬高型心肌梗死 空腹血糖 微血管阻塞 

分 类 号：R522.2[医药卫生—内科学]