摘要
目的 探讨伴2型糖尿病(T2DM)的急性心肌梗死(acute myocardial infarction, AMI)患者经皮冠状动脉介入治疗(PCI)术后近期发生主要不良心血管事件(MACE)的危险因素。方法 回顾性分析2016年8月-2020年1月在开封市人民医院行PCI术的147例伴T2DM的AMI患者临床资料及术后3个月内MACE发生情况。根据术后3个月内是否发生MACE分为MACE组和正常组,比较两组患者术后72 h内血糖变异性相关参数[血糖标准差(SDBG)、日平均血糖波动幅度(MAGE)、日间血糖平均绝对值(MODD)、餐后血糖波动幅度(PPGE)]及术后总胆固醇(TC)、超敏C反应蛋白(hs-CRP)水平和左室射血分数(LVEF),分析患者MACE发生的危险因素。结果 PCI术后3个月内MACE发生率为23.81%。MACE组患者术后72 h内SDBG、MAGE、MODD、PPGE和术后hs-CRP水平均显著高于正常组(t=10.206~24.388,P<0.05),术后LVEF则低于正常组(t=8.711,P<0.05);术后MAGE≥4.50 mmol/L、PPGE≥3.50 mmol/L、hs-CRP≥10 mg/L和LVEF<50%均为T2DM的AMI患者PCI术后近期发生MACE的独立危险因素(OR=3.927~7.501,P<0.05)。结论 PCI术后血糖变异性参数升高且伴T2DM的AMI患者术后3个月内更易发生MACE,术后72 h内血糖变异性参数水平升高、术后hs-CRP水平升高和LVEF降低是导致伴T2DM的AMI患者PCI术后近期发生MACE的危险因素,应加以防治。
Objective To investigate risk factors for short-term major adverse cardiovascular events(MACE)following percutaneous coronary intervention(PCI)in patients with acute myocardial infarction(AMI)with type 2 diabetes mellitus(T2DM).Methods We retrospectively analyzed the clinical data of 147 patients with AMI with T2DM who underwent PCI in Kaifeng people’s Hospital from August 2016 to January 2020 as well as their information on MACE within 3 months after PCI.The patients were divided into MACE group and normal group according to whether MACE occurred or not within 3 months after operation.The two groups were compared in terms of blood glucose variability within 72 h after operation as well as total cholesterol(TC),high-sensitivity C-reactive protein(hs-CRP),and left ventricular ejection fraction(LVEF)after operation.The risk factors for the occurrence of MACE were analyzed.Results The incidence of MACE within 3 months after PCI was 23.81%.The MACE group showed significantly higher levels of SDBG,MAGE,MODD,and PPGE within 72 h after operation and a significantly higher hs-CRP level after operation(t=10.206-24.388,P<0.05)and a significantly lower LVEF after operation(t=8.711,P<0.05)compared with the normal group.And postoperative MAGE≥4.50 mmol/L,PPGE≥3.50 mmol/L,hs-CRP≥10 mg/L,and LVEF<50%were independent risk factors for the short-term occurrence of MACE after PCI in patients with AMI with T2DM(OR=3.927-7.501,P<0.05).Conclusion There is a higher possibility of MACE within 3 months after PCI for AMI in patients with T2DM with increased glycemic variability parameters after operation.Increased glycemic variability parameters within 72 h after operation and increased hs-CRP levels and decreased LVEF after operation are risk factors for short-term MACE following PCI in patients with AMI with T2DM,which should be paid attention to.
作者
娄东亮
白玉晓
姜威锋
张好好
孙继红
LOU Dongliang;BAI Yuxiao;JIANG Weifeng;ZHANG Haohao;SUN Jihong(Department of Endocrinology,Kaifeng People’s Hospital,Kaifeng 475000,China)
出处
《精准医学杂志》
2023年第6期521-524,529,共5页
Journal of Precision Medicine
基金
河南省医学科技攻关计划联合共建项目(LHGJ-20190090)。
关键词
心肌梗死
糖尿病
2型
经皮冠状动脉介入治疗
心血管疾病
血糖
回顾性研究
Myocardial infarction
Diabetes mellitus,type 2
Percutaneous coronary intervention
Cardiovascular diseases
Blood glucose
Retrospective studies
作者简介
通讯作者:娄东亮,Email:ldl345@sohu.com。
