糖化血红蛋白变异指数与2型糖尿病患者发生支架内再狭窄的相关性分析  

Analysis of relationship between hemoglobin glycation index and instent restenosis in patients with type 2 diabetes mellitus

作　　者：仇杰 王如珠 王健[1] 宋桂仙[1] QIU Jie;WANG Ru-zhu;WANG Jian;SONG Gui-xian(Department of Cardiovascular Medicine,Taizhou People’s Hospital Affiliated to Nanjing Medical University,Taizhou 225300,Jiangsu,China)

机构地区：[1]南京医科大学附属泰州市人民医院心血管内科,江苏泰州225300

出　　处：《心脏杂志》2023年第6期648-651,660,共5页Chinese Heart Journal

基　　金：江苏省卫生健康委科研项目(M2022075)。

摘　　要：目的 探讨糖化血红蛋白变异指数(HGI)与2型糖尿病患者经皮冠状动脉介入(PCI)术后发生支架内再狭窄(ISR)与未发生支架内再狭窄(NISR)的相关性。方法 回顾性分析2019年10月~2022年10月在泰州市人民医院心内科行PCI术且于术后(8~24)月因胸痛复发或医师动员复查冠状动脉造影的2型糖尿病患者(n=134)。根据复查造影结果分为两组,其中ISR组(n=40),NISR组(n=94),分析两组患者基本临床特征、实验室检查、用药以及介入治疗情况之间的差异。采用多因素Logistic回归分析2型糖尿病患者发生ISR的影响因素。采用受试者工作特征曲线(ROC)分析HGI预测2型糖尿病患者发生ISR的效能。结果 ISR组患者糖化血红蛋白(HbA1c)、HGI均高于NISR组(P<0.01),年龄、残余脂蛋白、Gensini评分、支架总长度均高于NISR组(P<0.05),平均支架直径低于NISR组(P<0.01);Logistic回归分析显示HGI是2型糖尿病患者发生ISR的独立危险因素(OR=2.534,95%CI:1.023~6.281,P<0.05)。ROC曲线示HGI预测2型糖尿病发生ISR的曲线下面积为0.777,当HGI取0.309时,其预测的灵敏度为72.5%,特异度为77.7%。结论 HGI与2型糖尿病患者发生ISR的风险独立相关,且HGI可作为预测2型糖尿病患者发生ISR的临床指标。AIM To investigate the relationship between hemoglobin glycation index(HGI) and in-stent restenosis(ISR) after percutaneous coronary intervention(PCI) in patients with type 2 diabetes mellitus.METHODS A retrospective analysis was performed on 134 patients with T2DM who underwent PCI in the Department of Cardiovascular Medicine,Taizhou People's Hospital from October 2019 to October 2022 and who underwent coronary angiography 8~24 months after surgery due to recurrence of chest pain or by doctor's advice.The patients were divided into two groups according to the examination results of angiography:ISR group(40 cases) and NISR group(94 cases).The differences of basic data,laboratory examinations,medication and interventional therapy between the two groups were analyzed.Multivariate logistic regression was used to analyze the influencing factors of ISR in patients with type 2 diabetes mellitus and receiver operating characteristic curve(ROC) was used to analyze the efficacy of HGI in predicting ISR in patients with type 2 diabetes.RESULTS The age,residual lipoprotein,glycosylated hemoglobin(HbA1c),HGI,Gensini score and total length of stent in ISR group were higher than those in NISR group,and the mean stent diameter was lower than that in NISR group,with statistical significance(P<0.05,P<0.01).Logistic regression analysis showed that HGI was an independent risk factor for ISR in patients with type 2 diabetes mellitus(OR=2.534,95%CI:1.023~6.281,P<0.05).ROC curve showed that the area under the curve of predicting ISR of patients with type 2 diabetes mellitus by HGI was 0.777.When HGI was 0.309,the predictive sensitivity was 72.5% and the specificity was 77.7%.CONCLUSION HGI is independently associated with the risk of ISR in patients with type 2 diabetes mellitus and HGI can be used as a clinical indicator to predict ISR in patients with type 2diabetes mellitus.

关 键 词：2型糖尿病 支架内再狭窄 冠心病 糖化血红蛋白变异指数 

分 类 号：R541.4[医药卫生—心血管疾病]