CAJ | 학술논문

目的探讨糖尿病患者血浆同型半胱氨酸（homocysteine，Hcy）水平与围术期心血管事件（PCE）的相关性。方法2011年10月至2012年10月，合并糖尿病的择期非心脏手术患者300例，根据Hcy水平分为N组（Hcy＜15.4滋mol/L，217例）和H组（Hcy≥15.4滋mol/L，83例）。记录患者一般临床资料及心血管危险因素，通过动态心电图（DCG）持续监测术后48h的PCE发生情况。结果59例发生PCE，发生率为19.7%；其中，N组PCE的发生率为15.7%，H组PCE的发生率为30.1%，两组差异有统计学意义（t=7.937，P=0.005）；两组患者hs- CRP、LDL、TG浓度和ECG异常比较差异有统计学意义（P＜0.05）。结论糖尿病患者Hcy水平与PCE的发生率及心血管危险因素的控制密切相关。
목적탐토당뇨병환자혈장동형반광안산（homocysteine，Hcy）수평여위술기심혈관사건（PCE）적상관성。방법2011년10월지2012년10월，합병당뇨병적택기비심장수술환자300례，근거Hcy수평분위N조（Hcy＜15.4자mol/L，217례）화H조（Hcy≥15.4자mol/L，83례）。기록환자일반림상자료급심혈관위험인소，통과동태심전도（DCG）지속감측술후48h적PCE발생정황。결과59례발생PCE，발생솔위19.7%；기중，N조PCE적발생솔위15.7%，H조PCE적발생솔위30.1%，량조차이유통계학의의（t=7.937，P=0.005）；량조환자hs- CRP、LDL、TG농도화ECG이상비교차이유통계학의의（P＜0.05）。결론당뇨병환자Hcy수평여PCE적발생솔급심혈관위험인소적공제밀절상관。
Objective To investigate the correlation between plasma homocysteine (Hcy) levels and perioperative cardio-vascular events (PCEs) in patients with diabetes mel itus undergoing non- cardial surgery. Methods From October 2011 to Oc-tober 2012, 300 diabetic patients underwent elective non- cardiac surgery, including 217 patients with normal plasma Hcy level (Hcy<15.4μmol/L, group N) and 87 with high Hcy level (Hcy≥15.4μmol/L, group H). Various risk factors including gender, age, BMI, ASA classification, fasting blood glucose, HbA1c, blood lipids, Hcy and hs- CRP levels, smoking history, hypertension, pre-operative ECG changes, anesthesia method and operative time were documented in al patients. PCEs were monitored by dy-namic electrocardiography(DCG) for 48h after surgery. Results Perioperative PCEs developed in 59 patients (19.7%). The inci-dences of PCEs were 15.7%and 30.1%in N and H groups, respectively (t=7.937, P=0.005). Compared with N group, hs- CRP, LDL and TG levels and preoperative ECG changes were higher in H group (P<0.05). Conclusion Plasma Hcy levels are closely correlated with the incidence of perioperative cardiovascular events and cardiovascular risk factors in diabetic patients undergo-ing non- cardiac surgery.