邓婷婷　　华永平　　席罡　　石秀明　　曾满生

[摘要] 目的 探討糖化血红蛋白（HbA1c）与冠心病患者经皮桡动脉穿刺介入治疗预后的相关性。 方法 回顾性分析2011年3月～2014年9月我院收治的237例经皮桡动脉穿刺介入治疗术治疗的冠心病患者临床病例资料。并按照糖尿病病史及HbAlc水平将其分为三组：合并糖尿病且HbA1c≥6.5%的冠心病患者（A组）41例；合并糖尿病且HbA1c<6.5%的冠心病患者（B组）27例；无糖尿病且HbA1c<6.5%的冠心病患者（C组）169例，比较三组患者术后不良心血管事件的发生率。 结果 随访6个月时，A组不良心血管事件发生率为24.39%，B组为14.81%，C组为10.65%，差异无统计学意义（P>0.05）。随访24个月时，A组不良心血管事件发生率为36.59%，B组为25.92%，C组为17.16%，A组和B组的不良心血管事件发生率明显高于C组，（A组+B组）与C组比较差异有统计学意义。结论 HbA1c与冠心病患者经皮桡动脉穿刺介入治疗术长期预后有关，临床可通过降低血糖、有效控制HbA1c水平，改善冠心病患者的长期预后。

[关键词] 冠心病；糖化血红蛋白；糖尿病；经皮桡动脉穿刺介入治疗

[中图分类号] R587.1；R541.4 [文献标识码] A [文章编号] 1673-9701（2017）10-0016-03

Analysis the relationship between HbA1c and prognosis of patients with coronary heart disease underwent percutaneous transradial intervention

DENG Tingting HUA Yongping XI Gang SHI Xiuming ZENG Mansheng

Department of Cardiology， the Third People's Hospital of Jingdezhen in Jiangxi Province，Jingdezhen 333000，China

[Abstract] Objective To explore the relevant research of glycosylated hemoglobin（HbA1c） and percutaneous radial artery puncture interventional treatment prognostic for patients with coronary heart disease（CHD）. Methods Retrospective analysis the clinical medical records of 237 patients with coronary heart disease（CHD） from March 2011 to September 2014 in our hospital for the treatment of percutaneous radial artery puncture. And according to the history of diabetes and HbA1c levels divided into three groups： patients of coronary heart disease combine with diabetes and HbA1c≥6.5%（group A） were 41 cases；patients of coronary heart disease combine with diabetes and HbA1c<6.5% （group B）were 27 cases；patients of coronary heart disease not have diabetes and HbA1c<6.5%（group C） were 169 cases， the incidences of adverse cardiovascular events of three groups were compared. Results Follow-up visit for six months， the incidence of adverse cardiovascular events of group A was 24.39%，that of group B was14.81%， that of group C was 10.65%， the differences were no statistically significant（P>0.05）. Follow-up visit for twenty-four months， the incidence of adverse cardiovascular events of group A was 36.59%， that of group B was 25.92%， that of group C was 17.16%， the incidence of adverse cardiovascular events of group A and group B was significantly higher than that of group C， the difference was statistically significant between the group （A+B）and group C. Conclusion HbA1c is related to the long-term prognosis of patients of coronary heart disease treatment with percutaneous radial artery puncture interventional，which can reduce blood glucose， effectively control HbA1c level in clinical， to improve the patients of coronary heart disease long-term prognosis.

[Key words] Coronary heart disease；Glycosylated hemoglobin；Diabetes；Percutaneous radial artery puncture interventional treatment

糖化血红蛋白（glycosylated hemoglobin，HbA1c）是美国糖尿病学会推出的监测糖尿病控制水平的“金标准”，它能有效反映个体测量前2～3个月的平均血糖水平[1-3]。已有研究证实，HbA1c与糖尿病并发症的发生密切相关[4]。关于HbA1c水平与经皮桡动脉穿刺介入治疗术后冠心病患者不良心血管事件发生的关系，目前相关的研究相对较少，本研究试图从这一角度出发展开研究，旨在为临床制定改善冠心病患者的预后策略提供指导，现报道如下。

1 资料与方法

1.1 一般资料

收集2011年3月～2014年9月我院收治的237例行经皮桡动脉穿刺介入治疗术的冠心病患者，患者均符合《经皮冠状动脉介入治疗指南》[5]中关于冠心病的诊断标准和ADA糖尿病诊断标准[6]，患者知情同意并签署知情同意书。……