急性心肌梗死合并糖尿病患者冠脉介入治疗后心室重构的变化

发布时间：2018-06-01 22:33

本文选题：急性心肌梗死 + 冠脉介入治疗　；参考：《山东医药》2017年01期

【摘要】：目的探讨糖尿病对急性心肌梗死患者冠脉介入治疗后心室重构的影响。方法选择急性ST段抬高型心肌梗死并行冠脉介入治疗患者115例,其中合并糖尿病37例(糖尿病组)。无糖尿病78例(非糖尿病组)。采用酶联免疫吸附法检测两组血清CPK、CK-MB、TC、HDL-C、LDL-C、TG、FPG、GHb A1c水平,采用心脏超声测定两组左室舒张末期容量(LVEDV)及左室收缩末期容量(LVESV)、左室射血分数(LVEF)、E/A、心脏等容舒张时间(IVRT)、室壁运动指数(WMSI);观察两组左室重构、心力衰竭、心电图ST段回落70%发生率。结果随访6个月,糖尿病组失访1例,死亡1例,非糖尿病组失访4例,死亡1例;余108例完成整个随访过程。PCI治疗6个月,两组血清CPK、CK-MB、TC、HDL-C、LDL-C、TG水平差异无统计学意义(P均0.05),FPG、GHb A1c差异有统计学意义(P均0.05);两组LVEDV、LVEF、E/A、IVRT差异无统计学意义(P均0.05),LVESV、WMSI差异有统计学意义(P均0.05)。糖尿病组心电图相应导联ST段回落70%的发生率低于非糖尿病组(17.14%vs 47.94%,P=0.003);有心力衰竭症状的患者糖尿病组比非糖尿病组多(37.14%vs 19.17%,P=0.008);行PCI治疗后心室重构的发生率糖尿病组与非糖尿病相比无统计学差异(37.14%vs 28.76%,P=0.082)。结论急性心肌梗死合并糖尿病患者PCI术后出现心力衰竭的概率比无糖尿病患者高,但与心室重构无直接关系。
[Abstract]:Objective to investigate the effect of diabetes mellitus on ventricular remodeling after coronary intervention in patients with acute myocardial infarction. Methods 115 patients with acute St segment elevation myocardial infarction and coronary intervention were selected, including 37 patients with diabetes mellitus (DM group). There were 78 cases without diabetes mellitus (non-diabetic group). The levels of HDL-CU LDL-CnLDL-C TGG GUGHb A1c in serum of two groups were detected by enzyme-linked immunosorbent assay (Elisa). Left ventricular end-diastolic volume (LVEDVV), left ventricular end-systolic volume (LVESVV), left ventricular ejection fraction (LVEF) E / A, isovolumic diastolic time (IVRTT) and wall motion index (WMSI) were measured by echocardiography in two groups, left ventricular remodeling and heart failure were observed. The incidence of St segment depression was 70%. Results of the 6 months follow-up, 1 case was lost, 1 case died, 4 cases were lost and 1 case died in the non-diabetic group, the remaining 108 cases completed the whole follow up procedure .PCI for 6 months. There was no significant difference in TG levels between the two groups (P < 0.05), and there was no significant difference between the two groups (P > 0.05), and there was no significant difference between the two groups in LVEDVV, LVEFV, E / V, AIVRT (P < 0.05), and there was significant difference in WMSI between the two groups (P < 0.05). The incidence of St segment receding 70% in the diabetic group was lower than that in the non-diabetic group (17.14 vs 47.94); the incidence of ventricular remodeling in the diabetic group with heart failure symptoms was 37.14 vs 19.17%; the incidence of ventricular remodeling in the diabetic group was significantly higher than that in the non-diabetic group. The incidence of ventricular remodeling in the diabetic group was significantly higher than that in the non-diabetic group. There was no statistical difference between non-diabetic patients and non-diabetic patients (37.14 vs 28.76). Conclusion the incidence of heart failure after PCI in patients with acute myocardial infarction and diabetes is higher than that in patients without diabetes, but it is not directly related to ventricular remodeling.
【作者单位】：河北大学附属医院;
【基金】：河北省科技厅科技支撑计划资助项目(14277786D)
【分类号】：R542.22;R587.1

【相似文献】