【摘要】：目的探索糖化血紅蛋白(HbA1c)與急性心肌梗死(AMI)經(jīng)皮冠狀動脈介入(PCI)術(shù)后無復(fù)流危險因素相關(guān)性。方法接受PCI的AMI患者中術(shù)后無復(fù)流65例為觀察組,術(shù)后血流正常灌注135例為對照組。結(jié)果兩組梗死前心絞痛史(χ~2=4.179,P=0.041)、術(shù)前心肌梗死溶栓(TIMI)血流分級(χ~2=7.729,P=0.005)差異顯著(P0.05);兩組血清中總膽固醇(TG)(t=1.146,P=0.253)、甘油三酯(TC)(t=1.017,P=0.310)、高密度脂蛋白膽固醇(HDL-C)(t=1.594,P=0.113)、低密度脂蛋白膽固醇(LDL)-C(t=0.746,P=0.456)、白細(xì)胞計數(shù)(WBC)(t=0.975,P=0.331)、肌鈣蛋白(c Tn I)(t=0.684,P=0.495)、肌酸激酶同工酶(t=0.958,P=0.339)差異無統(tǒng)計學(xué)意義(P0.05);觀察組HbA1c水平高于對照組(t=2.467,P=0.015);不同HbA1c濃度的兩組患者在糖尿病史、HbA1c、心功能Killip分級、左室室射血分?jǐn)?shù)(LVEF)水平具有統(tǒng)計學(xué)差異(P0.05);運用Logistic回歸分析方法分析兩組HbA1c升高組PCI術(shù)后無復(fù)流危險因素發(fā)現(xiàn),糖尿病史、梗死前心絞痛、術(shù)前TIMI血流分級、HbA1c、LVEF水平是AMI HbA1c升高組PCI術(shù)后無復(fù)流的獨立危險因素。結(jié)論 HbA1c升高PCI術(shù)無復(fù)流患者心肌收縮功能受限進(jìn)一步影響左心室收縮功能。糖尿病史、梗死前心絞痛、術(shù)前TIMI血流分級增加、HbA1c水平升高、左室功能受損是AMI HbA1c升高組患者PCI術(shù)后無復(fù)流的獨立危險因素。
[Abstract]:Objective to investigate the correlation between glycosylated hemoglobin (HbA1c) and no reflow risk factors after percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI). Methods 65 patients with AMI who received PCI were treated as observation group and 135 patients with normal blood flow as control group. Results the history of pre-infarction angina pectoris (蠂 ~ 2 / 24.179 / P0.041), preoperative thrombolytic (TIMI) grade (蠂 ~ (2 +) 7.729 / P ~ (0.005), serum total cholesterol (TG) (1.146), triglyceride (TC) () t1.017 (0.310), high-density lipoprotein cholesterol (HDL-C) (t _ (1.594) P _ (0.113), low density lipoprotein cholesterol (LDL) _ C (t _ (0.746P _ (0.456), leucocyte count) were significantly different between the two groups (P0.05). There was no significant difference in the number of (WBC) (t0. 975 (P < 0. 331), troponin (c Tn I) (0. 684) P0. 495), creatine kinase isoenzyme (t0. 958% P0. 339) (P0.05), the level of HbA1c in the observation group was higher than that in the control group (t = 2. 467 P0. 015), there was no significant difference between the two groups in the history of diabetes mellitus (HbA1c., Killip grade), there was no significant difference between the two groups (P0. 015). There was significant difference in left ventricular ejection fraction (LVEF) between the two groups (P0.05). The results of Logistic regression analysis showed that there were no risk factors of reflow after PCI in the two groups of HbA1c elevation group, diabetes history, angina pectoris before infarction, Preoperative TIMI blood flow grade and HbA1cU LVEF level were independent risk factors for no reflow after PCI in patients with elevated AMI HbA1c. Conclusion the left ventricular systolic function is further affected by the increase of HbA1c in patients without reflow after PCI. Diabetes history, pre-infarction angina pectoris, increased preoperative TIMI blood flow grade and increased HBA _ 1c level, left ventricular dysfunction were independent risk factors for no reflow after PCI in patients with elevated AMI HbA1c.
【作者單位】： 滄州市人民醫(yī)院;
【分類號】：R542.22

【參考文獻(xiàn)】

相關(guān)期刊論文 前2條

1 王軍;華琦;李康;王麗;王云飛;李小明;薛淞;江大川;孔強(qiáng);胡少東;張鈺聰;邵強(qiáng);劉馬超;趙霞;王姍;韓濤;金蔚英;王競雄;李靜;;急性心肌梗死再灌注時機(jī)對患者預(yù)后的影響[J];中國心血管雜志;2014年06期

2 Koushik Reddy;Asma Khaliq;Robert J Henning;;Recent advances in the diagnosis and treatment of acute myocardial infarction[J];World Journal of Cardiology;2015年05期

【共引文獻(xiàn)】

相關(guān)期刊論文 前2條

1 黃貴奇;李德棟;羅理寧;王俊誼;顏程光;;老年前壁急性心肌梗死患者高側(cè)壁下壁導(dǎo)聯(lián)ST段變化預(yù)測前降支阻塞的部位[J];中華老年心腦血管病雜志;2015年11期

2 楊曉偉;程何祥;陶凌;王海昌;苑媛;;重視并提高心電向量理論在心電圖教學(xué)中的地位[J];中國醫(yī)學(xué)創(chuàng)新;2015年21期

相關(guān)碩士學(xué)位論文 前1條

1 楊秋香;丹參素冰片酯對缺氧復(fù)氧誘導(dǎo)H9c2細(xì)胞損傷的保護(hù)作用及其機(jī)制研究[D];西北大學(xué);2015年

【二級參考文獻(xiàn)】

相關(guān)期刊論文 前3條

1 趙映;陳韻岱;田峰;王長華;胡舜英;王晶;楊俊杰;;急性心肌梗死患者急診PCI術(shù)后無復(fù)流的危險因素分析[J];南方醫(yī)科大學(xué)學(xué)報;2012年02期

2 徐廣馬;胡昌興;林英忠;劉伶;覃紹明;伍廣偉;林虹;;急診經(jīng)皮冠狀動脈介入術(shù)開通梗死相關(guān)血管時程變化對急性ST段抬高型心肌梗死早期預(yù)后的影響[J];臨床心血管病雜志;2011年08期

3 ;Assessment of left ventricular segmental function after autologous bone marrow stem cells transplantation in patients with acute myocardial infarction by tissue tracking and strain imaging[J];Chinese Medical Journal;2005年14期

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 夏菁;冠脈無復(fù)流現(xiàn)象治療的研究進(jìn)展[J];現(xiàn)代診斷與治療;2005年05期

2 程璐;;急診經(jīng)皮冠狀動脈介入術(shù)無復(fù)流與左心功能恢復(fù)的關(guān)系[J];遼寧醫(yī)學(xué)雜志;2006年06期

3 陳桂英;周立君;黃永麟;李為民;;冠脈無復(fù)流現(xiàn)象的臨床意義及處理[J];中國實用內(nèi)科雜志;2007年02期

4 荀平;高航;;冠脈無復(fù)流現(xiàn)象的診治進(jìn)展[J];心臟雜志;2007年06期

5 楊秀秀;陳韻岱;;無復(fù)流現(xiàn)象的預(yù)防與治療[J];心肺血管病雜志;2008年01期

6 張春震;趙郁;;冠狀動脈無復(fù)流現(xiàn)象的防治進(jìn)展[J];中國現(xiàn)代醫(yī)生;2008年10期

7 郭任維;任艷琴;邢愛華;王全義;呂曉春;郝愛萍;;經(jīng)皮冠狀動脈介入術(shù)中無復(fù)流現(xiàn)象臨床分析[J];中國介入心臟病學(xué)雜志;2009年05期

8 劉玉鵬;王曉麗;;經(jīng)皮冠狀動脈介入治療術(shù)中無復(fù)流現(xiàn)象的研究進(jìn)展[J];新醫(yī)學(xué);2010年02期

9 施佳;歐少君;金惠根;;藥物防治無復(fù)流研究進(jìn)展[J];心血管病學(xué)進(jìn)展;2010年02期

10 張艷芳;;無復(fù)流現(xiàn)象的基礎(chǔ)與臨床[J];中國實用醫(yī)藥;2010年30期

相關(guān)會議論文 前10條

1 黃東;馬劍英;王翔飛;張峰;錢菊英;葛雷;葛均波;;經(jīng)微導(dǎo)管使用不同血管擴(kuò)張劑對急診經(jīng)皮冠狀動脈介入治療術(shù)中無復(fù)流現(xiàn)象的療效比較[A];中華醫(yī)學(xué)會第11次心血管病學(xué)術(shù)會議論文摘要集[C];2009年

2 朱升四;劉俊;周旭晨;朱皓;鄭曉群;曲新凱;黃榕，

本文編號：2236834