并发2型糖尿病的稳定型心绞痛患者经皮冠状动脉介入治疗后微循环功能评价被引量：10

Evaluation of microcirculation function in stable angina pectoris patients complicated with type 2 diabetes mellitus after percutaneous coronary intervention

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摘要目的探讨微循环阻力指数(index of microcirculatory resistance,IMR)对合并2型糖尿病的稳定型心绞痛患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后微循环障碍的诊断价值。方法选取常州市金坛区人民医院2013年2月至2016年2月期间接受PCI治疗的稳定型心绞痛患者68例,其中合并有2型糖尿病的患者32例,不合并有2型糖尿病的患者36例。记录患者临床资料,并计算IMR。对两组的一般临床资料及PCI治疗后IMR进行相关性分析。结果合并有2型糖尿病的稳定型心绞痛患者经PCI治疗后,血流储备分数(fractional flow reserve,FFR)、冠状动脉血流储备分数(coronary flow reserve,CFR)、高敏C-反应蛋白(high sensitivity C-reactive protein,hs-CRP)、肌酸激酶同工酶(creatine kinase isoenzyme MB、CK-MB)、肌钙蛋白浓度均高于不合并2型糖尿病的患者,差异有统计学意义(P<0.01)。生化指标与IMR之间均无明显相关性(P均>0.05)。结论合并有糖尿病的稳定型心绞痛患者较非糖尿病患者更易出现冠状动脉微循环障碍,可能与糖尿病患者更易发生炎性反应有关。压力导丝测定IMR能较准确、敏感地反映稳定型心绞痛合并2型糖尿病患者的冠状动脉微循环情况。 Objectives To investigate the value of index of microcirculatory resistance（IMR）on evaluating microcir-culation disturbance of stable angina pectoris patients complicated with type 2 diabetes mellitus after percutaneous coro-nary intervention（PCI）. Methods Totally 68 patients with stable angina pectoris treated by PCI from February 2013 to February 2016 in The People′s Hospital of Jintan District were selected. Among them ,32 patients combined with type 2 diabetes mellitus and 36 did not combine with type 2 diabetes mellitus. Clinical data were recorded and IMR was calculated. Correlations analysis of IMR and clinical data were performed. Results Fractional flow reserve （FFR）,coronary flow reserve（CFR）and concentrations of high sensitivity C-reactive protein（hs-CRP）,creatine kinase isoenzyme MB（CK-MB）,troponin in stable angina pectoris patients complicated with type 2 diabetes mellitus after PCI were significantly higher than those of patients not complicated with type 2 diabetes mellitus（P〈0.01）. Corre-lations analysis showed that the upper indexes did not correlate with IMR after PCI（P〉0.05）. Conclusions Stable an-gina pectoris patients complicated with type 2 diabetes mellitus are more likely to have coronary microcirculation distur-bance comparing to the patients not complicated with type 2 diabetes mellitus ,maybe result in diabetic patients are more susceptible to occur inflammatory reaction. IMR can accurately and sensitively reflect the coronary microcircula-tion in patients with stable angina pectoris combined with type 2 diabetes.

作者乔华李益民李穗吉于文敏周磊

机构地区常州市江苏大学附属金坛医院心内科南京市胸科医院心内科

出处《岭南心血管病杂志》 2017年第5期521-524,529,共5页 South China Journal of Cardiovascular Diseases

关键词心绞痛 2型糖尿病血管成形术经腔经皮冠状动脉微循环障碍 angina type 2 diabetes mellitus percutaneous coronary intervention microcirculation disturbance

分类号 R541.4 [医药卫生—心血管疾病]

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