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目的观察急性心肌梗死经急诊冠状动脉介入治疗(PCI)后心电图ST段下降幅度与糖化血红蛋白(HbA1c)的相关性。方法将急诊PCI术成功后1h的18导联心电图与患者入院当时心电图比较,分别测定梗死相关导联最大ST段偏移振幅,按抬高ST段下降幅度分为A、B两组。A组ST段下降≥50%,B组ST段下降<50%,均测定HbA1c,并确定是否合并糖尿病,对其相关性的观察进行比较。结果两组患者比较,A组患者经急诊PCI后心电图ST段下降幅度大,HbA1c数值偏低,合并糖尿病患者较少,而B组患者经急诊PCI后心电图ST段下降幅度小,HbA1c数值偏高(p<0.05),合并糖尿病患者较多(p<0.01),两组比较差异有统计学意义。结论急性心肌梗死患者经急诊PCI术后心电图ST段下降幅度与HbA1c数值呈明显相关,可以作为早期干预的指标,并有助于进一步指导AMI治疗。
Objective To investigate the relationship between the decrease of ST segment and the HbA1c level after acute coronary intervention (PCI) in acute myocardial infarction. Methods The 18-lead electrocardiogram of 1h after emergency PCI was compared with the electrocardiogram at the time of hospital admission. The maximum amplitude of ST-segment deviation of infarction-related lead was measured. The amplitude of ST-segment depression was divided into A and B groups. A group of ST segment decreased ≥ 50%, B group ST-segment decreased <50%, were measured HbA1c, and determine whether the merger of diabetes, the correlation between the observations were compared. Results Compared with the two groups, the decrease of ST segment of ECG and the lower value of HbA1c in patients of group A after PCI were less in patients with diabetes mellitus, while the decrease of ST segment in ECG and the high value of HbA1c in group B after PCI (p <0.05), more patients with diabetes mellitus (p <0.01), the difference between the two groups was statistically significant. Conclusion The decrease of ST segment of ECG after acute PCI in patients with acute myocardial infarction is significantly correlated with the value of HbA1c, which can be used as an index of early intervention and help to guide the further treatment of AMI.