糖尿病患者糖化血红蛋白水平与围术期心血管事件的关系

Correlation between HbA1c and perioperative cardiovascular events in patients with diabetes mellitus

目的探讨糖尿病患者糖化血红蛋白(HbA1c)水平与围术期心血管事件(PCE)的关系。方法将合并糖尿病的择期非心脏手术患者500例根据HbA1c水平分为A组(HbA1c<6.5%,376例)和B组(HbA1c≥6.5%,124例)。记录两组患者一般临床资料及心血管危险因素,通过动态心电图持续观测术后48h的PCE发生情况。结果 79例(15.8%)发生PCE,其中A组PCE的发生率是13.3%,B组为23.4%,差异有统计学意义(=0.008)。两组患者空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白和心电图异常差异均有统计学意义(均<0.05)。结论糖尿病患者HbA1c水平与PCE的发生率及心血管危险因素的控制有密切关系。

Objective To investigate the correlation between HbAlc and perioperative cardiovascular events （PCEs） in patients with diabetes mellitus. Methods According to HbA1 c levels, 500 diabetic patients undergoing elective non- cardiac surgery were divided into group A （HbAlc 〈 6.5%, n=376） and group B （HbAlc 〉~6.5%, n=124）. Various risk factors including sex, age, body mass index （BMI）, ASA classification, fasting blood glucose, HbAlc, blood lipids, smoking history, hypertension and preoperative electrocardiogram （ECG） changes were documented in all patients. Dy- namic electrocardiogram （DCG） monitoring was kept for 48h after surgery.Results PCEs developed in 79 patients （15.8%） during periopemtion. The incidences of PCEs were 13.3% and 23.4% in A and B groups respectively, and there was significant difference （P=0.008）. Compared with A group, fasting blood glucose, total cholesterol（TC）,triglycerin （TG）and high density lipoprotein（HDL） levels and preoperative ECG changes were higher in B group （P 〈 0.05）. Con- clusions HbAlc level was closely related to the incidence of PCEs and cardiovascular risk factors.