黄欣,罗永百,吴昊谕,陈方圆,张勇,方媛,郭宁

• 1:西安交通大学第一附属医院心血管内科

摘要(Abstract)：

目的利用血管内超声(IVUS)技术探讨非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者入院糖化血红蛋白(HbA_(1c))水平与冠状动脉病变特点的关系。方法 118例NSTE-ACS患者按照入院时HbA_(1c)水平以三分位法分为低水平组(HbA_(1c)≤5.6%)、中水平组(HbA_(1c)5.7%~6.4%)、高水平组(HbA_(1c)≥6.5%),对罪犯病变进行IVUS检查。结果与HbA_(1c)低水平组及中水平组相比,高水平组患者平均体重指数较高,糖尿病史、血脂异常病史比例更高。HbA_(1c)高水平组患者三支病变(52.4%比16.7%比25.0%)、弥漫性病变(61.9%比11.1%比15.0%)较低水平组及中水平组更为多见;但单支病变(19.0%比58.3%比45.0%)、局限病变(14.3%比61.1%比60.0%)较低水平组及中水平组更为少见,差异均有统计学意义(均P<0.01)。IVUS检查结果显示,HbA_(1c)高水平组患者最小管腔面积[(2.81±0.61)mm~2比(3.50±0.47)mm~2比(3.53±0.53)mm~2]较低水平组以及中水平组更小,斑块负荷[(86.83±3.93)%比(75.59±3.48)%比(75.15±4.93)%]、重构指数[(1.34±0.95)比(0.90±0.19)比(1.12±0.11)]较低水平组以及中水平组更高,软斑块(47.6%比22.2%比30.0%)、破裂斑块(52.4%比16.7%比45.0%)较低水平组以及中水平组更为常见,纤维斑块(9.5%比30.6%比20.0%)、混合斑块(21.4%比33.3%比35.0%)较低水平组以及中水平组更为少见,差异均有统计学意义(均P<0.01)。结论入院HbA_(1c)水平与NSTE-ACS患者冠状动脉病变的易损性有关。

关键词(KeyWords)： 急性冠状动脉综合征;糖化血红蛋白;血管内超声

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81170138);; 陕西省自然科学基础研究计划(2017JM8104)

作者(Author): 黄欣,罗永百,吴昊谕,陈方圆,张勇,方媛,郭宁

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