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

[1]	LIU Yi, QIN Ling, REN Jiaojiao, YANG Yuansu, ZHANG Wenqiu. Application of family-centered diversified extended services in treating retinopathy of premature infants[J]. Journal of Clinical Medicine in Practice, 2024, 28(11): 102-106. DOI: 10.7619/jcmp.20231759
[2]	YIN Hang. Research progress on immune checkpoint inhibitors therapy for non-small cell lung cancer with positive driver gene[J]. Journal of Clinical Medicine in Practice, 2023, 27(10): 144-148. DOI: 10.7619/jcmp.20223698
[3]	XU Xiaohang, GAO Hui, ZHAO Jiwei, WANG Yongxiang, SHI Xueqiang, SUN Hao. Risk factors of delirium in patients with severe multiple trauma in trauma center[J]. Journal of Clinical Medicine in Practice, 2022, 26(19): 38-41. DOI: 10.7619/jcmp.20221502
[4]	LU Mingfeng, JI Ling. Characteristics and countermeasures of emergency patients in chest pain, stroke and trauma centers in tertiary hospital during epidemic of Coronavirus Disease 2019[J]. Journal of Clinical Medicine in Practice, 2022, 26(3): 120-124. DOI: 10.7619/jcmp.20214280
[5]	LI Binbin. Application of PDCA cycle management in emergency treatment[J]. Journal of Clinical Medicine in Practice, 2018, (10): 94-96. DOI: 10.7619/jcmp.201810027
[6]	HU Lanping, LIANG Yanmei. Application of root cause analysis in prevention of adverse events in hematodialysis center[J]. Journal of Clinical Medicine in Practice, 2017, (18): 30-32. DOI: 10.7619/jcmp.201718010
[7]	SHAO Hong, XIE Fang. Effect of chest pain center reperfusion process nursing on success rate of patients with acute myocardial infarction[J]. Journal of Clinical Medicine in Practice, 2017, (6): 22-24. DOI: 10.7619/jcmp.201706007
[8]	YU Linlin. Effect of cluster nursing on emergency treatment of patients with severe heat stroke[J]. Journal of Clinical Medicine in Practice, 2016, (8): 34-36,46. DOI: 10.7619/jcmp.201608011
[9]	LIANG Junhua, LI Juan. Effect of emergency nursing process on curative efficiency for acute cerebral infarction patients[J]. Journal of Clinical Medicine in Practice, 2014, (8): 75-77. DOI: 10.7619/jcmp.201408025
[10]	YANG Jianhua. Application of crisis management in high quality nursing service in sterile supply center[J]. Journal of Clinical Medicine in Practice, 2013, (18): 175-176,186. DOI: 10.7619/jcmp.201318072

Cited By

Cited by

Periodical cited type(15)

1.	崔浩鹏，李铭，王海彬，夏旭东，范晓云. 乳腺X线与彩超联合检查在乳腺癌筛查中的临床意义. 齐齐哈尔医学院学报. 2024(07): 658-660 .
2.	霍晓恺，宁欣欣，鲍金双，李福强，龙见渊，秦宪涛. 超声联合UE诊断老年乳腺良恶性病变的价值. 中国现代普通外科进展. 2024(09): 731-733 .
3.	袁中明，袁晚荣. 乳腺超声检查和乳腺钼靶检查在乳腺癌筛查中的应用价值分析. 航空航天医学杂志. 2023(01): 25-27 .
4.	李莹，王安武. 乳腺磁共振动态增强扫描协同超声及乳腺X射线摄影在乳腺癌筛查及腋窝淋巴结转移中的价值. 中国现代医生. 2023(01): 47-51 .
5.	陈雪红. 乳腺癌彩超检查与X射线钼靶检查相比较及相结合的诊断应用. 中国医疗器械信息. 2023(04): 113-115+155 .
6.	孟娜娜. 乳腺超声筛查对早期乳腺癌的应用效果及价值. 影像研究与医学应用. 2023(12): 134-136 .
7.	武壮壮，张晓娟，史泽洪，史瑶，原韶玲. 超声、钼靶及两者联合对高级别与中低级别乳腺导管原位癌的诊断价值. 实用医学杂志. 2022(05): 560-564 .
8.	庞志英，吴晓燕，姚文虹，赵仕懂，李智锋，陈志武. 乳腺肿块患者实施X线钼靶与超声检查的临床价值分析. 实用医学影像杂志. 2022(02): 172-174 .
9.	李春涛，党小珂. 乳腺癌患者钼靶X线诊断的影像学特征分析. 医药论坛杂志. 2022(18): 50-52 .
10.	李志湄，刘业培，焦洪斌. 钼靶DR摄影联合DCE-MRI在乳腺肿块良恶性鉴别中的应用价值. 中国医疗设备. 2022(10): 79-82+100 .
11.	冶月惠. 实时剪切波弹性成像技术联合BI-RADS分类标准在乳腺良恶性病变鉴别诊断中的价值. 影像研究与医学应用. 2022(21): 88-90 .
12.	戴慧萍，张丹丹，邱慧芳. 超声联合乳腺钼靶在乳腺癌筛查中的应用. 实用临床医学. 2022(06): 46-47+91 .
13.	董佳，张卫彬. 彩色多普勒超声和超声弹性成像及X射线钼靶检查对乳腺癌诊断价值探讨. 社区医学杂志. 2022(23): 1316-1320 .
14.	庄伟伟. 乳腺癌诊断中超声与X线钼靶的联用分析. 影像研究与医学应用. 2021(10): 153-154 .
15.	许伟，孙传喜. 乳腺超声与钼靶联合检查在乳腺癌筛查中的效果评估. 影像研究与医学应用. 2021(23): 33-34 .

Other cited types(0)

Get Citation

PDF

XML

Article views (125) PDF downloads (5) Cited by(15)

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