老年糖尿病合并稳定型心绞痛患者糖基化产物水平与冠状动脉介入治疗预后的关系
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海后卫生部科研课题(BHJ09JD08)


Relationship of serum levels of glycosylated products with prognosis in elderly type 2 diabetic patients after percutaneous coronary intervention for stable angina
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    摘要:

    目的 检测冠心病稳定型心绞痛合并2型糖尿病老年患者冠状动脉介入术前的血糖及糖基化产物水平,了解其与介入治疗短期预后的关系。方法 连续选取2010年1月至2012年12月于海军总医院住院接受冠状动脉介入治疗的稳定型心绞痛合并2型糖尿病老年患者188例,根据是否出现缺血并发症如复发心绞痛、心肌梗死及死亡,将患者分为事件组和对照组;观察两组心血管病术前临床危险因素、血糖、糖基化产物(糖化血红蛋白和糖化血清蛋白)及高敏C反应蛋白水平的差异,评价各组术前危险因素、糖代谢及炎症反应指标的差异。结果 事件组与对照组相比较,年龄、性别、体质量指数、吸烟史、高血压及高脂血症发病率、用药情况以及糖化血红蛋白水平差异均无统计学意义(P>0.05);空腹血糖、糖化血清蛋白以及高敏C反应蛋白水平明显增高(P<0.01);以220μmol/L为界值,糖化血清蛋白升高患者出现围术期缺血并发症的风险明显增加(OR=2.96,95%CI:1.50~5.81,P=0.001)。结论 糖基化产物中,术前糖化血清蛋白水平增高可能是糖尿病合并稳定型心绞痛老年患者冠状动脉介入治疗围术期缺血并发症的危险预测指标。

    Abstract:

    Objective To investigate the pre-operative serum levels of glycosylated products in the elderly type 2 diabetes mellitus patients with stable angina undergoing selective percutaneous coronary intervention(PCI), and evaluate the relationship between the levels and short-term outcomes. Methods A total of 188 elderly patients with diabetes and stable angina who were treated with PCI in our hospital from January 2010 to December 2012 were consecutively enrolled in this study. The patients were divided into 2 groups according to onset of post-procedure outcome events, the control group(no event) and the event group(ischemic events: post-procedure angina, myocardial infarction and death). The profiles of clinical cardiovascular risk factors, levels of fasting blood glucose, glycosylated products [glycosylated hemoglobin A1c(HbA1c) and glycosylated serum protein(GSP)] and high sensitivity C reactive protein(hs-CRP) were collected before PCI and compared between 2 groups. Results There was no significant difference in the age, gender, body mass index, history of smoking, incidences of hypertension and hyperlipidemia, medication, and serum HbA1c level between 2 groups(P>0.05). However, the patients in event group had significantly higher levels of fasting blood glucose, GSP and hs-CRP than those in control group(P<0.01). The risk of complicating post-procedure ischemic events in the patients with higher GSP levels(>220μmol/L) was much higher than that in patients having lower GSP levels(OR=2.96, 95% CI=1.50-5.81, P=0.001). Conclusion Elevated GSP level before PCI may be a risk factor of post-procedure ischemic events in the elderly patients with diabetes and stable angina undergoing selective PCI.

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刘丽丽*, 李贤峰, 刘 敏, 刘振华, 何疆春.老年糖尿病合并稳定型心绞痛患者糖基化产物水平与冠状动脉介入治疗预后的关系[J].中华老年多器官疾病杂志,2013,12(10):756~759

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  • 在线发布日期: 2013-11-06
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