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胰岛素抵抗在急性心肌梗死患者经皮冠状动脉介入治疗术后再狭窄中的作用 被引量:5

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摘要 目的探讨胰岛素抵抗与非糖尿病患者急性心肌梗死经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)后再狭窄(restenosis,RS)的关系。方法非糖尿病急性心梗患者62例,据是否存在胰岛素抵抗(insulinresistance,IR)分为IR组(n=38)和非IR组(NIR组,n=24),均行PCI,每例患者植入1-2枚药物洗脱支架。采集清晨空腹静脉血,检测空腹血糖(FBG)、空腹胰岛素(FBI)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-c)、高密度脂蛋白胆固醇(HDL-c)、甘油三酯(TG)。用自我平衡模型分析法计算胰岛素敏感指数(insulin sensitivity index,ISI)。计算患者体质量指数(BMI)。术后6-8个月再次冠脉造影。测定冠脉病变长度和术前、支架植入后及复查造影时血管最小内径,计算RS发生率、血管管腔直径丢失值和血管内径丢失指数。结果2组患者在年龄、性别构成比、高血压患病率、BMI、血TC、TG、HDL-c、LDL-c、冠脉病变长度、支架术前最小管腔直径、支架术后即刻最小管腔直径和术后即刻管腔残留狭窄程度差异皆无统计学意义。IR组FBG、FBI及ISI在IR组皆高于NIR组(P〈0.05,P〈0.01)。IR组有5例(13.2%)患者出现RS,NIR组1例(4.2%)出现RS,2组间比较有统计学差异(P〉0.05)。IR组管腔丢失值和丢失指数皆大于NIR组(P〈0.01)。ISI与管腔丢失值和丢失指数呈明显正相关(r=0.811、r=0.821;P〈0.01)。结论非糖尿病急性心肌梗死患者IR程度与急诊PCI后冠脉支架内RS有关。
出处 《第三军医大学学报》 CAS CSCD 北大核心 2010年第7期725-727,共3页 Journal of Third Military Medical University
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共引文献48

同被引文献79

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