2017 年第 10 期 第 12 卷

糖化血红蛋白对急性心肌梗死患者直接经皮冠状动脉介入术后梗死相关动脉血流及预后的影响

Effects of glycosylated hemoglobin on infarct-related artery flow and prognosis in patients after primary percutaneous coronary intervention for acute myocardial infarction

作者：高玉龙李莉娜张京梅陶英李志忠

英文作者：Gao Yulong Li Lina Zhang Jingmei Tao Ying Li Zhizhong

单位：100029首都医科大学附属北京安贞医院心内科（高玉龙、张京梅、陶英、李志忠）；063200河北省唐山市曹妃甸区医院心内科（李莉娜）

英文单位：Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China(Gao YL Zhang JM Tao Y Li ZZ); Department of Cardiology Tangshan City Caofeidian District Hospital Hebei Province Tangshan 063200 China(Li LN)

关键词：急性心肌梗死；糖化血红蛋白；冠状动脉介入；梗死相关动脉

英文关键词：Acutemyocardialinfarction;Glycosylatedhemoglobin;Coronaryintervention;Infarct-relatedartery

• 摘要：

• Objective  To investigate effects of glycosylated hemoglobin(HbA1c) on infarct-related artery flow and prognosis in patients after primary percutaneous coronary intervention(PPCI) for acute myocardial infarction(AMI). Methods  Clinical data of 502 patients with AMI who had PPCI from January to December 2013 in Beijing Anzhen Hospital, Capital Medical University were retrospectively analyzed. The patients were divided into HbA1c≥6.5% group（193 cases）and control group（309 cases）. Baseline data, results of coronary angiography, operation data and prognosis were analyzed. Results  Male rate, left ventricular ejection fraction, postoperative thrombolysis in myocardial infarction（TIMI） grade 3 rate and ST-segment drop rate in HbA1c≥6.5% group were significantly lower than those in control group［66.2%（128/193） vs 72.1%（223/309）, （50±10）% vs （53±11）%, 92.5%（179/193） vs 96.7%（299/309）, 88.4%（171/193） vs 93.8%（290/309）］（P<0.05）. Age, hypertension rate, time between AMI attack and admission, time of infarct-related artery patency, postoperative no reflow/slow flow rate and in-hospital mortality rate in HbA1c≥6.5% group were significantly higher(longer) than those in control group［（62±10）years vs （61±11）years, （8.4±2.1）h vs （7.7±2.2）h, （84±15）min vs （79±12）min, 7.5%（14/193） vs 3.3%（10/309）, 2.9%（6/193） vs 0.5%（2/309）］（P<0.05）. Logistic regression analysis showed that HbA1c was an independent risk factor of in-hospital mortality (odds ratio=2.036, 95% confidence interval: 0.977-3.987, P=0.031). Conclusion  Patients with high level of HbA1c have poor heart function and coronary flow after PPCI; HbA1c is a risk factor of post-PPCI death.