Relationship of impaired glucose regulation with slow flow or no reflow during percutaneous coronary intervention in patients with ST segment elevation myocardial infarction

MIAO Rui; ZHANG Man; WANG Xuezhi; HAO Yafeng; LIN Li; QUAN Huijuan

doi:10.7619/jcmp.20234122

Journal of Clinical Medicine in Practice > 2024 > 28(9): 40-44, 51. > DOI: 10.7619/jcmp.20234122

MIAO Rui, ZHANG Man, WANG Xuezhi, HAO Yafeng, LIN Li, QUAN Huijuan. Relationship of impaired glucose regulation with slow flow or no reflow during percutaneous coronary intervention in patients with ST segment elevation myocardial infarction[J]. Journal of Clinical Medicine in Practice, 2024, 28(9): 40-44, 51. DOI: 10.7619/jcmp.20234122

Citation:

PDF (1157 KB)

Relationship of impaired glucose regulation with slow flow or no reflow during percutaneous coronary intervention in patients with ST segment elevation myocardial infarction

the Second Department of Cardiology, Handan City First Hospital of Hebei Province, Handan, Hebei, 056000

More Information

Received Date: December 18, 2023
Revised Date: March 11, 2024
Available Online: May 14, 2024

Graphical Abstract

Abstract

Abstract

Objective
To investigate the relationship between impaired glucose regulation (IGR) and slow flow or no reflow (SF/NRF) during percutaneous coronary intervention (PCI) in patients with ST segment elevation myocardial infarction (STEMI).
Methods
Clinical materials of 80 STEMI patients with SF/NRF and 84 STEMI patients without SF/NRF in the hospital from October 2021 to October 2022 were retrospectively collected, including blood glucose, total cholesterol (TC), triglyceride (TG), cardiac troponin Ⅰ (cTnⅠ), fibrinogen, left ventricular ejection fraction (LVEF), D-dimer, uric acid, homocysteine, the ratio of absolute value of neutrophils to absolute value of lymphocytes (NLR), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C) and 2 h postprandial blood glucose level. Logistic regression model was used to analyze the influencing factors of SF/NRF in STEMI patients with PCI; the receiver operating characteristic (ROC) curve was used to analyze the diagnostic value of fasting blood glucose and 2 h postprandial blood glucose levels for SF/NRF in STEMI patients with PCI.
Results
Compared with non-SF/NRF group, the levels of cTnⅠ, fibrinogen and HDL-C in SF/NRF group were significantly higher, while the levels of systolic blood pressure (SBP), diastolic blood pressure (DBP) and NLR were significantly lower (P < 0.05). Compared with non-SF/NRF group, the stent diameter, stent length and the time from chest pain to catheter room in SF/NRF group were significantly longer (P < 0.05). The levels of fasting blood glucose and 2 h postprandial blood glucose in SF/NRF group were significantly higher than those in non-SF/NRF group (P < 0.05). Logistic regression analysis showed that fasting blood glucose and 2 h postprandial blood glucose were the influencing factors of SF/NRF in STEMI patients with PCI, and the area under the curve (AUC) of the combination of the two indicators for diagnosis of SF/NRF in STEMI patients during PCI was significantly higher than that by fasting blood glucose and 2 h postprandial blood glucose alone (Z=3.272, 4.369, P < 0.001).
Conclusion
IGR is related to SF/NRF during PCI in STEMI patients, and fasting blood glucose and 2 h postprandial blood glucose levels are the influencing factors of SF/NRF in STEMI patients.

FullText(HTML)

References (22)

References

[1]	蒋能美, 管鑫娟, 杨社珍. 生长停滞特异性蛋白6和C1q/肿瘤坏死因子相关蛋白4水平与2型糖尿病患者颈动脉粥样硬化的关联[J]. 实用临床医药杂志, 2023, 27(5): 123-127. doi: 10.7619/jcmp.20223211
[2]	陈涛, 张大勇, 袁明, 等. 急性ST段抬高心肌梗死患者血清miRNA-499a与心肌损伤标志物的相关性分析[J]. 心血管病学进展, 2020, 41(9): 994-998. https://www.cnki.com.cn/Article/CJFDTOTAL-XXGB202009026.htm
[3]	林东升, 何仲春, 罗辉. 急性ST段抬高型心肌梗死伴高血栓负荷患者急诊及择期经皮冠状动脉介入治疗策略研究[J]. 实用心脑肺血管病杂志, 2021, 29(1): 10-14, 20. https://www.cnki.com.cn/Article/CJFDTOTAL-SYXL202101003.htm
[4]	陆泽宇, 高山. STEMI患者PCI术后慢血流/无复流现象的研究进展[J]. 微量元素与健康研究, 2022, 39(5): 80-82. https://www.cnki.com.cn/Article/CJFDTOTAL-WYJK202205030.htm
[5]	李婧, 李小凤, 刘玲娇, 等. 胰岛素抵抗代谢评分与中老年人糖调节受损及糖尿病的相关性研究[J]. 现代检验医学杂志, 2022, 37(6): 52-57. https://www.cnki.com.cn/Article/CJFDTOTAL-SXYN202206010.htm
[6]	俞婷婷, 吴韩, 王昆. 非糖尿病STEMI患者直接PCI术后空腹血糖与微血管阻塞的相关性分析[J]. 临床心血管病杂志, 2022, 38(3): 197-201. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXB202203007.htm
[7]	中华医学会心血管病学分会, 中华心血管病杂志编辑委员会. 急性ST段抬高型心肌梗死诊断和治疗指南(2019)[J]. 中华心血管病杂志, 2019, 47(10): 766-783. https://www.cnki.com.cn/Article/CJFDTOTAL-ZJXB201709002.htm
[8]	中华医学会糖尿病分会. 2007年版中国2型糖尿病防治指南[J]. 中华内分泌代谢杂志, 2008, 24(2): 增录1-附录26. https://www.cnki.com.cn/Article/CJFDTOTAL-HLSJ202309001.htm
[9]	谢维, 邓君, 毕小容, 等. 脉压、脉压指数的测定在冠状动脉粥样硬化性心脏病并缺血性卒中患者冠状动脉病变、预后评估中的作用分析[J]. 中国分子心脏病学杂志, 2022, 22(4): 4793-4797. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGFB202204008.htm
[10]	刘明涛. 尼可地尔在ST段抬高型心肌梗死患者介入治疗中对患者微血管功能障碍的影响[J]. 中国药物与临床, 2021, 21(22): 3712-3714. https://www.cnki.com.cn/Article/CJFDTOTAL-YWLC202122026.htm
[11]	高曼, 白文楼, 成思瑶, 等. 院前负荷量替格瑞洛与氯吡格雷对转运PCI的急性STEMI患者术后慢血流/无复流及短期预后的影响[J]. 中国老年学杂志, 2021, 41(13): 2689-2692. https://www.cnki.com.cn/Article/CJFDTOTAL-ZLXZ202113001.htm
[12]	吴美善, 李江华, 刘霞, 等. 心肌声学造影对冠状动脉狭窄临界病变功能性评价的有效性及可靠性分析[J]. 中西医结合心脑血管病杂志, 2021, 19(3): 461-463. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYYY202103022.htm
[13]	王玉霞, 刘英华, 卢海英, 等. 急性冠状动脉综合征患者PCI术前血清ICAM-1、ESM-1水平与术后冠状动脉慢血流/无复流的相关性[J]. 疑难病杂志, 2022, 21(2): 124-129. https://www.cnki.com.cn/Article/CJFDTOTAL-YNBZ202202004.htm
[14]	姜礼杰, 梁伟涛, 岳洪华, 等. 欧洲呼吸病学会"慢性血栓栓塞性肺动脉高压专家共识" 解读[J]. 中华结核和呼吸杂志, 2021, 44(11): 1021-1024. https://xuewen.cnki.net/CCND-NCRB202404170010.html
[15]	杨丽萍, 刘晓, 张晓辉. 造血干细胞移植相关血栓性微血管病的诊疗进展[J]. 中华血液学杂志, 2021, 42(8): 693-699. https://www.cnki.com.cn/Article/CJFDTOTAL-CZXX202003052.htm
[16]	郑士航, 高曼, 张飞飞, 等. GRACE评分联合中性粒细胞与淋巴细胞比值对急性STEMI患者PCI后无复流现象的预测价值[J]. 临床心血管病杂志, 2021, 37(9): 810-815. https://www.cnki.com.cn/Article/CJFDTOTAL-LCXB202109007.htm
[17]	王小兵, 熊富权, 林德智, 等. ST段抬高心肌梗死患者入院时中性粒细胞计数与经皮冠状动脉介入治疗后血管造影无复流的关系[J]. 徐州医科大学学报, 2020, 40(4): 268-273. https://www.cnki.com.cn/Article/CJFDTOTAL-XZYX202004009.htm
[18]	安鑫. 应激性高血糖对非糖尿病急性心肌梗死患者PCI术后心肌灌注、预后的影响[J]. 山东第一医科大学: 山东省医学科学院学报, 2022, 43(1): 41-44. https://www.cnki.com.cn/Article/CJFDTOTAL-TSYX202201011.htm
[19]	陈一蕊, 勾朝阳, 李新阳. 急性心肌梗死并糖尿病患者糖化血红蛋白和脑钠肽的检测价值分析[J]. 黑龙江中医药, 2021, 50(6): 250-251. https://www.cnki.com.cn/Article/CJFDTOTAL-HLZY202106185.htm
[20]	杨洁, 丁文萃, 王海英, 等. 含动态血糖分析的2型糖尿病慢性并发症风险预测模型及效能评价[J]. 疑难病杂志, 2022, 21(8): 822-827. https://www.cnki.com.cn/Article/CJFDTOTAL-YNBZ202208009.htm
[21]	SIA C H, CHAN M H, ZHENG H L, et al. Optimal glucose, HbA1c, glucose-HbA1c ratio and stress-hyperglycaemia ratio cut-off values for predicting 1-year mortality in diabetic and non-diabetic acute myocardial infarction patients[J]. Cardiovasc Diabetol, 2021, 20(1): 211.
[22]	闫岩, 刘文博, 郭成龙, 等. T2DM合并AMI患者血糖水平与替格瑞洛、氯吡格雷对血小板功能影响的关系[J]. 心血管康复医学杂志, 2021, 30(6): 690-694. https://www.cnki.com.cn/Article/CJFDTOTAL-XXGK202106013.htm

Cited By

Cited by

Periodical cited type(5)

1.	刘生玲. 疏肝和胃方联合四联疗法治疗肝胃气滞型胃溃疡临床观察. 中国中医药现代远程教育. 2024(15): 146-149 .
2.	黄萍，伍灵志. 康复新液联合四联疗法对Hp阳性胃溃疡患者炎症因子及胃肠道激素水平的影响. 中国医学创新. 2023(12): 26-29 .
3.	王嘉菲，田洲，王蕾，陈娟. 颗粒蛋白前体、E-钙黏附蛋白在良恶性胃溃疡组织中的表达及临床意义. 实用临床医药杂志. 2022(15): 50-56 . 本站查看
4.	崔岩，王天明，潘海邦. 三七白及类方剂辅助治疗消化性溃疡临床效果的meta分析. 中国当代医药. 2022(23): 5-9 .
5.	张静，张鸿博. 中医药治疗幽门螺杆菌相关性胃溃疡研究. 医学信息. 2022(20): 173-176 .

Other cited types(2)

Get Citation

PDF

XML

Article views (125) PDF downloads (5) Cited by(7)

Turn off MathJax

Article Contents

Abstract

References

Relationship of impaired glucose regulation with slow flow or no reflow during percutaneous coronary intervention in patients with ST segment elevation myocardial infarction

Abstract

References

Cited by

Periodical cited type(5)

Other cited types(2)

Catalog

Export File

Citation

Format

Content