冠心病介入治疗患者预后与糖化血红蛋白水平相关性

Correlation between the prognosis and glycosylated hemoglobin A_1c level in patients with coronary heart disease after percutaneous coronary intervention

目的探讨行经皮冠状动脉介入术(percutaneous coronary intervention,PCI)治疗的冠心病患者的预后与糖化血红蛋白(glycosylated hemoglobin A1c,HbA1c)水平的相关性。方法 76例行PCI治疗的冠心病患者,35例HbA1c≥6.5%为观察组,41例HbA1c<6.5%为对照组。比较2组术后3、6、12个月预后不良事件发生率,并分析其与HbA1c水平的相关性。结果观察组中合并糖尿病24例,对照组合并糖尿病13例,2组比较差异有统计学意义(P<0.05);2组术后3、6、12个月不良事件发生情况以及PCI术后3个月总预后不良事件发生率比较差异无统计学意义(P>0.05);观察组PCI术后6、12个月总预后不良事件发生率(28.57%、42.58%)高于对照组(7.32%、14.63%)(P<0.05),且观察组PCI术后12个月总预后不良事件发生率(42.85%)高于术后3个月(14.29%)(P<0.05)。结论冠心病PCI预后与患者HbA1c水平有关,HbA1c水平较高者预后较差,控制HbA1c水平,尤其是对合并糖尿病的患者,对改善预后有重要意义。

Objective To explore the correlation between the prognosis and the level of glycosylated hemoglobin A1 c （HbA1 c） in patients with coronary heart disease after percutaneous coronary intervention （PCI）. Methods The clinical data of 76 patients with coronary heart disease after PCI were retrospectively analyzed and were divided into observation group （n=35） with HbA1c≥6.5% and control group （n=41） with HbA1c〈6.5%. The 3 , 6- and 12-month adverse reactions were observed and compared between two groups after operation to analyze their correlations with HbA1 c levels. Results In observation group, 24 patients were complicated with diabetes, and in control group only 13 patients were complicated with diabetes, showing a significant difference between two groups （P〈0.05）. There were no significant differences in the incidences of 3-, 6- and 12-month adverse reactions and incidence of 3-month total adverse reactions between two groups （P〈0.05）. The 6- and 12-month incidences of adverse reactions were significantly higher in observation group （28.57%, 42.58%） than those in control group （7.32%, 14.6%〈） （P〈0.05） and higher than that of 3-month total adverse reactions （14.29%%） （P〈0.05）. Conclusion The prognosis is correlated with H bA1 c level in patients with coronary heart disease after PCI, and the patients with higher HbA1c level have worse prognosis. To control HbA1 c level is very important for improving the prognosis, especially for the patients complicated with diabetes.