HbA1c水平对PCI术后冠心病伴糖尿病患者心血管不良事件的影响

The Effect of Hb A1c Level on the Incidence of MACE in Postoperative Patients of CHD & DM after PCI Therapy

目的:探讨糖化血红蛋白(Hb A1c)水平与经皮冠状动脉介入治疗(PCI)术后冠心病(CHD)伴糖尿病患者心血管不良事件(MACE)发生率的关系。方法:行PCI治疗的CHD患者83例,根据入组患者的Hb A1c水平将其分为A、B两组,A组(Hb A1c<6.5%)38例,B组(Hb A1c≥6.5%)45例,比较两组患者资料、术前术前C反应蛋白(CRP)、血沉(ESR)、肿瘤坏死因子(TNF-α)及白介素6(IL-6)水平、观察2组经PCI治疗后6和24月MACE发生率。结果:A组患者术前的CRP、TNF-α水平均显著低于B组(t=5.944、5.095,P<0.01),两组ESR及IL-6差异无统计学意义(P>0.05);治疗6月后,A、B两组患者MACE结果差异无统计学意义(P>0.05);治疗24月后A组患者出现心梗、病变血管再狭窄的比例均低于B组,差异有统计学意义(χ2=5.385、6.629,P=0.020、0.010)。结论:PCI术后,与高Hb A1c患者比较,Hb A1c水平低的CHD伴糖尿病患者的预后较好。

Objective： To explore the relationship of HbAlc level with the incidence of adverse car- diovascular events （MACE） of CHD ＆ DM patients after PCI therapy. Methods： Eighty-three cases of CHD ＆ DM patients after PCI operation were selected and divided into group A （HbAlc 〈 6.5% ） and group B （HbAlc≥6.5%）,with 38 cases in group A and 45 in group B. The preoperative CRP, ESR, TNF-ot IL-6 in group A and group B were compared and MACE incidences were observed in 6 months and 24 months after PCI respectively. Results： The preoperative average CRP and TNF-ct lev- els in group A were obviously higher than those in group B （ t = 5. 944, 5. 095, P 〈 0.01 ）, but the differences of ESR and IL-6 levels were not significant between groups A and B. The MACE incidence in 6 months after PCI therapy was not significantly different between groups A and B （ P 〉 0.05 ） ; But in 24 months after PCI therapy, the proportion of myocardial infarction and vascular restenosis in the patients in group A was significantly lower than that in group B （X2 = 5. 385, 6. 629 ; P = 0. 020, 0. 010）. Conclusion： After PCI therapy, the prognosis of CHD ＆ DM patients with lower HbAlc level is better than that of patients with higher HbAlc level.