急诊PCI后ST段下降幅度与HbA1c的相关性

To observe the relations between ST-segment resolution and Glycosylated hemoglobin in patients with acute myocardial infarction and treated by primary percutaneous coronary intervention

目的观察急性心肌梗死经急诊冠状动脉介入治疗(PCI)后心电图ST段下降幅度与糖化血红蛋白(HbA1c)的相关性。方法将急诊PCI术成功后1h的18导联心电图与患者入院当时心电图比较,分别测定梗死相关导联最大ST段偏移振幅,按抬高ST段下降幅度分为A、B两组。A组ST段下降≥50%,B组ST段下降<50%,均测定HbA1c,并确定是否合并糖尿病,对其相关性的观察进行比较。结果两组患者比较,A组患者经急诊PCI后心电图ST段下降幅度大,HbA1c数值偏低,合并糖尿病患者较少,而B组患者经急诊PCI后心电图ST段下降幅度小,HbA1c数值偏高(p<0.05),合并糖尿病患者较多(p<0.01),两组比较差异有统计学意义。结论急性心肌梗死患者经急诊PCI术后心电图ST段下降幅度与HbA1c数值呈明显相关,可以作为早期干预的指标,并有助于进一步指导AMI治疗。

Objective To study the relations between ST-segment resolution and Glycosylated hemoglobin in patients with acute myocardial infarction（AMI）and treated by primary percutaneous coronary intervention（PCI）.Method To collect the electrocardiogram result before PCI and one hour after PCI,measure the ST-segment elevation of infarct-related lead of 18 lead electrocardiogram before and after PCI.Patients were classified into two groups according to ST-segment resolution,group A with ST-segment resolution≥50%,and group B with ST-segment resolution50%,HbA1c were measured,and to determine whether the patients had diabetes.Results ST-segment resolution and HbA1c value were compared between the two groups,patients in A group who had emergency PCI had big decline in electrocardiogram ST segment,and their HbA1c value was low,and fewer patients with diabetes mellitus,while patients in group B after emergency PCI had relatively little ST-segment resolution,and higher HbA1c values（p0.05）,more patients with diabetes mellitus（p0.01）,the difference was statistically significant.Conclusion ST-segment resolution significantly associated with HbA1c values,early intervention is useful indicators of clinical treatment and is helpful for clinical therapy in patients with acute myocardial infarction.