血糖及糖化血红蛋白水平对糖尿病合并急性心肌梗死患者行PCI术后预后的影响

Effect of Blood Glucose and Glycated Hemoglobin Levels on the Prognosis of Patients with Diabetes Mellitus Complicated with Acute Myocardial Infarction After PCI

目的分析血糖及糖化血红蛋白水平对糖尿病合并急性心肌梗死患者行PCI术后预后的影响。方法随机选取天津医科大学总医院于2017年1月-2018年1月间收治的糖尿病合并急性心肌梗死患者80例,根据患者术前血红糖化蛋白(HbA1c)水平将其分成对照组与观察组。HbA1c≤6.5%患者有40例,将其纳入对照组,HbA1c>6.5%有40例将其纳入观察组。PCI手术前后检测血糖及HbA1c水平、心功能及统计预后。结果术前观察组患者HbA1c、FPG、TC、TG水平高于对照组(P<0.05),术后降低;其中观察组HbA1c、FPG、TC、TG水平高于对照组患者(P<0.05)。术前两组患者左心室舒张期内径(LVDd)、左心射血分数(LVEF)水平差异无统计学意义(P>0.05),术后改善;其中观察组患者LVDd低于对照组(P<0.05),LVEF水平高于对照组(P<0.05)。观察组患者再发心肌梗死率、心源性休克率、频发室性期收缩率高于对照组(P<0.05)。HbA1c、FPG、TC、TG是影响预后的主要危险因素(P<0.05)。结论 PCI手术前高血糖及HbA1c水平会影响PCI术后预后,积极评估血糖及HbA1c水平有利于预后。

Objective To investigate the effect of blood glucose and glycated hemoglobin levels on the prognosis of patients with diabetes mellitus complicated with acute myocardial infarction after PCI.Methods 80 patients with diabetes mellitus and acute myocardial infarction admitted to the hospital from January,2017 to January,2018 were randomly selected, and divided into two groups according to the preoperative hemoglobin(HbA1c)level, including observation group(n=40) and control group(n=40).The blood glucose and glycated hemoglobin levels, as well as the cardiac function were monitored, and the prognosis was also recorded.Results The levels of HbA1c, FPG, TC and TG were higher in the observation group than in the control group before operation(P<0.05),which were decreased in both groups after operation(P<0.05),and still higher in the observation group than in the control group(P<0.05). LVDd and LVEF levels showed no difference between the two groups before operation(P>0.05),but were improved in both groups after operation. Observation group had lower LVDd level and higher LVEF level than those of control group(P<0.05). The rates of recurrent myocardial infarction, cardiogenic shock and frequent ventricular systole in the observation group were higher than those in the control group(P<0.05). HbA1c, FPG, TC and TG were the main risk factors affecting prognosis(P<0.05).Conclusion High blood glucose and glycated hemoglobin levels before PCI will affect the prognosis after PCI, so the assessment of the indicators can improve the prognosis.