老年经皮冠状动脉介入患者血糖水平与心肌灌注及不良心脏事件的关系

发布时间：2019-04-17 16:08

【摘要】：目的探讨老年经皮冠状动脉介入手术(PCI)患者血糖水平与心肌灌注及不良心脏事件的关系。方法接受PCI再灌注治疗的急性ST段抬高型心肌梗死(STEMI)患者394例,根据患者的血糖水平分成对照组(血糖水平7.0 mmol/L)136例及血糖上升组(血糖水平7.0~11.1 mmol/L)148例、高血糖组(血糖水平11.1 mmol/L)110例。对比各组PCI术后的心肌灌注和心功能指标,随访6个月,记录患者的不良心脏事件发生情况,Logistic回归分析评价影响PCI术后不良心脏事件的危险因素。结果血糖上升组与高血糖组肌酸激酶同工酶(CK-MB)峰值明显高于对照组,左室射血分数(LVEF)水平、ST段回落较好及心肌灌注的血流分级(TMPG)2~3级的比例明显低于对照组,高血糖组CK-MB峰值明显高于血糖上升组,LVEF水平明显低于血糖上升组(均P0.05)。394例患者PCI术后发生不良心脏事件者62例(15.74%)。PCI术后发生不良心脏事件者存在应激性高血糖(SHG)、TMPG 0~1级、吸烟及泵衰竭≥Ⅱ级的比例均分别明显高于未发生不良心脏事件者(均P0.05),且Logistic回归分析显示,上述4个指标均是影响PCI术后不良心脏事件的危险因素。结论老年PCI患者的血糖水平与其心肌灌注以及不良心脏事件之间均存在紧密联系,存在SHG、TMPG 0~1级、吸烟以及泵衰竭≥Ⅱ级会增加PCI术后不良心脏事件发生风险。
[Abstract]:Objective to investigate the relationship between blood glucose level and myocardial perfusion and adverse cardiac events in elderly patients undergoing percutaneous coronary intervention (PCI). Methods A total of 394 (STEMI) patients with acute ST segment elevation myocardial infarction were treated with PCI reperfusion. According to the blood glucose level of the patients, there were 136cases in the control group (7.0mmol/L), 148cases in the elevated blood glucose group (7.0x11.1 mmol/L), and 110 cases in the hyperglycemia group (11.1 mmol/L). The indexes of myocardial perfusion and cardiac function after PCI were compared in each group. The adverse cardiac events were recorded after 6 months of follow-up. The risk factors of adverse cardiac events after PCI were evaluated by Logistic regression analysis. Results the peak value of creatine kinase isoenzyme (CK-MB) in hyperglycemia group and hyperglycemia group was significantly higher than that in control group. Left ventricular ejection fraction (LVEF) (LVEF) level was significantly higher than that in control group. The percentage of blood flow grade (TMPG) 2 / 3 in myocardial perfusion group was significantly lower than that in control group, and the peak value of CK-MB in hyperglycemia group was significantly higher than that in hyperglycemia group. The level of LVEF was significantly lower than that of the elevated blood glucose group (all P0.05). There were 62 cases (15.74%) with adverse cardiac events after PCI (15.74%) with stress hyperglycemia (SHG), TMPG 0 grade 1, and there was no significant difference between the two groups (P < 0.05). The rates of smoking and pump failure grade 鈪，

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