门诊老年冠心病合并糖尿病患者血清BDNF变化、血脂检验及行PCI治疗观察

The changes of serum BDNF,blood lipid and PCI in the elderly patients with coronary heart disease complicated with diabetes mellitus

目的:比较分析了门诊收治的冠心病合并糖尿病患者血清BDNF变化、血脂检验及行PCI治疗情况,为临床治疗冠心病合并糖尿病患者提供一定参考依据及思路。方法:选择本院门诊收治的老年冠心病合并糖尿病患者126例纳入冠心病合糖尿病组,同期收治的单纯冠心病患者125例纳入冠心病组,另外选择同期体检健康者120例纳入健康对照组,排除冠心病、糖尿病及肝胆类等疾病。所有患者根据Gensini积分系统及冠状动脉血管图像分段评价标准,对每条血管的狭窄程度进行评价。检测各组总胆固醇(TC)、甘油三脂(TG)、低密度蛋白(LDL-C)、高密度蛋白(HDL-C)、载脂蛋白A1(APOA-1)及载脂蛋白B(APOB)等指标。比较冠心病合并糖尿病组及单纯冠心病组支架数目、平均直径及支架长度情况。结果:冠心病合糖尿病组Gensini评分及血清BDNF浓度均高于冠心病组及对照组,冠心病组Gensini评分及血清BDNF浓度均高于对照组,差异均具有统计学意义(P<0.05);冠心病合糖尿病组及冠心病组血脂中TC、TG、LDL-C、APO-B水平均明显高于对照组,而HDL-C和APOA-1水平均明显低于对照组,冠心病合糖尿病组血脂中TC、TG、LDL-C、APO-B水平均明显高于冠心病组,差异均有统计学意义(P<0.05);冠心病合糖尿病组支架置入的数目及长度均高于冠心病组,体内置入支架的平均直径小于冠心病组,差异均具有统计学意义(P<0.05)。结论:冠心病合并糖尿病患者血清中BDNF与冠状动脉狭窄程度具有一定相关性,临床应加强血脂相关指标检测,并结合其他辅助检查,以减少动脉粥样硬化及心血管事件的发生,在治疗时选用合适支架,对冠心病合并糖尿病患者具有理想的治疗效果。

Objective： To compare the clinic from coronary heart disease complicated with diabetes mellitus patients serum BDNF changes,blood tests and PCI,for the clinical treatment of coronary heart disease in patients with diabetes mellitus provide certain reference and ideas. Methods： in outpatient of our hospital of elderly patients with coronary heart disease in patients with diabetes mellitus complicated with 126 cases into coronary heart disease combined with diabetes mellitus group,CHD patients admitted in the same period of 125 cases into coronary heart disease group and healthy subjects during the same period in 120 cases into the healthy control group,to exclude coronary heart disease,diabetes and liver and other diseases. All patients according to Gensini integration system and coronary artery vascular image segmentation evaluation criteria for each of the degree of vascular stenosis were evaluated.Total cholesterol（ TC）,glycerin three fat（ TG）,low density protein（ LDL-C）,high density protein（ HDL-C）,apolipoprotein A1（ APOA-1） and apolipoprotein B（ APOB） and other indicators were detected. The number of stents,mean diameter and length of stent in patients with coronary heart disease combined with diabetes mellitus and coronary heart disease group were compared. Results： coronary heart disease with diabetes mellitus group Gensini score and serum BDNF concentrations were higher in CHD group and control group,CHD group Gensini score and serum BDNF concentrations were significantly higher than the control group,the differences were statistically significant（ P〈0. 05）; coronary heart disease and coronary heart disease group and blood fat group in TC,TG,LDL-- C,diabetes,APO- B levels were significantly higher than that of control group HDL-C and APOA-1 were significantly lower than control group,coronary heart disease and diabetes group in TC,TG,LDL-C,blood lipid and APO- B level were significantly higher in CHD group,the differences were statistically significant（ P〈0. 05）; the number and length of coronary heart disease in diabetic group were higher than that of the stent stent in coronary heart disease group,mean diameter of less than the coronary heart disease group,the differences were statistically significant（ P〈0. 05）. Conclusion： the coronary heart disease patients with diabetes mellitus in serum brain- derived neurotrophic factor（ BDNF） and coronary artery stenosis has certain correlation,clinical should strengthen the blood lipid and other related indicators detection,combined with other auxiliary examination,in order to reduce the occurrence of atherosclerosis and cardiovascular events,in the treatment of selected suitable scaffold,on coronary diabetic patients with good therapeutic effect.