血糖控制水平对糖尿病患者冠状动脉微循环阻力指数的影响

摘要

目的:观察血糖控制水平对糖尿病患者冠状动脉微循环阻力指数(IMR)的影响.方法:抽取2013年1月至2016年12月在我院经冠状动脉造影确诊为冠心病,且通过压力导丝法测定有IMR和离子交换法测定(glycosylated hemoglobin,HbA1c)数据的患者224例.其中非糖尿病患者一组4.0％≤HbA1c ＜6.0％;糖尿病患者按照HbA1c水平分为4.0％≤HbA1c＜6.0％、6.0％≤HbA1c＜7.0％、7.0％≤HbA1c＜8.0％、HbA1c≥8.0％4组.比较5组患者HbA1c水平与IMR的关系,探讨HbA1c对糖尿病患者IMR的影响.结果:5组比较结果显示,HbA1c水平相同的情况下非糖尿病患者的IMR低于糖尿病患者(P＜0.05);糖尿病患者中,随着HbA1c水平的升高IMR值也会升高(P＜0.05).结论:积极控制血糖有利于改善糖尿病患者的IMR,血糖控制不良是糖尿病患者IMR升高的危险因素.%Objective:To observe the effects of blood glucose control level on index of microcirculatory resistance (IMR) in patients with diabetes.Methods:A total of 224 patients with coronary heart disease diagnosed by coronary angiography and IMR data measured by pressure wire method and HbA1c data measured by ion exchange method were collected from January 2013 to December 2016 in our hospital.The non-diabetic group was divided according to the HbA1c level of 4％ ≤HbA1c ＜6.0％ while the diabetic patients were divided into four groups according to HbA1c level:4.0％ ≤HbA1c ＜6.0％,6.0％ ≤HbA1c ＜.0％,7.0％ ≤HbA1c ＜8.0％ and HbA1c≥8.0％.The relationship of HbA1c and IMR among the five groups was compared,and the effect of HbA1c on IMRof diabetic patients was studied.Results:The comparison among the 5 groups showed that the IMR of non-diabeticpatients was lower than that of diabetic patients when HbA1 c level was the same (P ＜ 0.05).In diabetic patients,the IMR value increased with the increase of HbA1c level (P ＜ 0.05).Conclusion:The active control of bloodsugar is beneficial to the improvement of IMR in patients with diabetes.While poor glycemic control is a risk factorfor the increase of IMR in diabetic patients.