急性ST段抬高型心肌梗死合并应激性高血糖患者围手术期应用GLP-1效果观察

发布时间：2018-03-23 13:38

本文选题：心肌梗死　切入点：应激性高血糖　出处：《山东医药》2017年06期

【摘要】：目的探讨急性ST段抬高型心肌梗死(STEMI)合并应激性高血糖(SHG)患者围手术期应用胰高血糖素样肽-1(GLP-1)对心肌灌注和心功能的影响。方法选择STEMI合并SHG患者114例,随机分为观察组59例和对照组55例。入院后均给予标准AMI强化治疗,观察组从急诊PCI术前至术后7 d给予GLP-1干预,对照组从急诊PCI术前至术后7 d给予胰岛素常规干预。于术后7 d及3个月采用静息~(99m)Tc-MIBI心肌灌注显像17节段积分法评价两组术后心肌灌注缺损积分,常规超声心动图测量左心室舒张末内径(LVEDD)、二维双平面Simpson法测量左心室射血分数(LVEF),胶体金免疫层析法检测不同时间点肌酸激酶同工酶(CK-MB)及肌钙蛋白T(cTnT)水平。结果两组术后3个月的心肌灌注缺损积分均较术后7 d降低,观察组术后3个月心肌灌注缺损积分较对照组同期降低(P0.01);两组术后3个月LVEDD、LVEF均较术后7 d升高,观察组术后3个月LVEF较对照组同期升高(P0.01);观察组围手术期CK-MB及cTnT峰值低于对照组(P均0.05)。结论 STEMI合并SHG患者围手术期应用GLP-1可以逐步改善心肌灌注及心脏功能。
[Abstract]:Objective to investigate the effect of glucagon-like peptide 1 (GLP-1) on myocardial perfusion and cardiac function in patients with acute ST-segment elevation myocardial infarction (STEMI) combined with stress hyperglycemia (SHG). Methods 114 patients with STEMI combined with SHG were selected. 59 cases were randomly divided into the observation group (59 cases) and the control group (55 cases). All of them were given standard AMI intensive treatment after admission, and the observation group received GLP-1 intervention from the time of emergency PCI operation to 7 days after operation. The control group was treated with routine insulin intervention from the time of emergency PCI operation to 7 days after operation, and the myocardial perfusion defect score was evaluated by 17 segment integration of 99mTc-MIBI myocardial perfusion imaging at 7 days and 3 months after operation in both groups. The left ventricular end-diastolic diameter was measured by conventional echocardiography, the left ventricular ejection fraction (LVEF) was measured by two-dimensional biplane Simpson, the levels of creatine kinase isoenzyme (CK-MBB) and troponin TcTnT were measured by colloidal gold immunochromatography at different time points. The score of myocardial perfusion defect at 3 months after operation in group A was lower than that at 7 days after operation. The score of myocardial perfusion defect in the observation group was lower than that in the control group at 3 months after operation (P 0.01), and the LVEF of LVEDDN in both groups was increased 3 months after operation compared with that at 7 days after operation. Compared with the control group, the value of CK-MB and cTnT in the observation group was lower than that in the control group (P 0.05) 3 months after operation. Conclusion GLP-1 can gradually improve myocardial perfusion and cardiac function in patients with STEMI combined with SHG during perioperative period.
【作者单位】：河北大学;河北大学附属医院;
【分类号】：R542.22

【相似文献】