CAJ | 학술논문

目的：评估入院糖化血红蛋白（HbAlc）水平对非糖尿病患者急性心肌梗死预后的影响。方法纳入2005年1月~2010年12月在湖北理工学院附属医院急性心肌梗死（AMI）且不合并糖尿病患者420例，所有患者在入院后即刻采血，采用比色法检测血糖（Glu）、高压液相层析法检测HbAlc。将患者根据入院HbAlc水平分为4组：3.5%≤HbAlc＜5.0%（n=122），5.0%≤HbAlc≤5.5%（n=87），5.5%≤HbAlc＜6.0%（n=109）和6.0%≤HbAlc＜6.5%（n=102）。主要研究终点为1年全因死亡率，次要终点是30天死亡率和CK-MB峰值。结果入组患者总体1年死亡率为13.57%，其中3.5%≤HbAlc＜5.0%组为8.2%，5.0%≤HbAlc＜5.5%组为11.5%，5.5%≤HbAlc＜6.0%组为13.8%，6.0%≤HbAlc＜6.5%组为21.6%，各组间均有统计学差异；但各组间30 d死亡率和CK-MB峰值无统计学差异（P＞0.05）。Cox回归模型显示HbA1c是1年死亡风险的独立预测因子（OR=1.2，P＜0.05）。结论急性心肌梗死的非糖尿病患者入院时HbA1c水平是患者1年死亡率的预测指标，HbA1c水平越高则患者1年死亡率越高。
목적：평고입원당화혈홍단백（HbAlc）수평대비당뇨병환자급성심기경사예후적영향。방법납입2005년1월~2010년12월재호북리공학원부속의원급성심기경사（AMI）차불합병당뇨병환자420례，소유환자재입원후즉각채혈，채용비색법검측혈당（Glu）、고압액상층석법검측HbAlc。장환자근거입원HbAlc수평분위4조：3.5%≤HbAlc＜5.0%（n=122），5.0%≤HbAlc≤5.5%（n=87），5.5%≤HbAlc＜6.0%（n=109）화6.0%≤HbAlc＜6.5%（n=102）。주요연구종점위1년전인사망솔，차요종점시30천사망솔화CK-MB봉치。결과입조환자총체1년사망솔위13.57%，기중3.5%≤HbAlc＜5.0%조위8.2%，5.0%≤HbAlc＜5.5%조위11.5%，5.5%≤HbAlc＜6.0%조위13.8%，6.0%≤HbAlc＜6.5%조위21.6%，각조간균유통계학차이；단각조간30 d사망솔화CK-MB봉치무통계학차이（P＞0.05）。Cox회귀모형현시HbA1c시1년사망풍험적독립예측인자（OR=1.2，P＜0.05）。결론급성심기경사적비당뇨병환자입원시HbA1c수평시환자1년사망솔적예측지표，HbA1c수평월고칙환자1년사망솔월고。
Objective To review the influence of glycosylated hemoglobin (HbA1c) on the prognosis in nondiabetic patients with acute myocardial infarction (AMI).Methods The AMI patients (n=420) without diabetes were chosen from Jan. 2005 to Dec. 2010. The blood samples were collected immediately after hospitalization for detecting the level of plasma glucose (Glu) by using chromatoptometry and detecting the level of HbA1c by using HPLC. All patients were divided, according to HbA1c level at being hospitalizing, into 3.5%≤HbAlc<5.0% group (group 1, n=122), 5.0%≤HbAlc<5.4% group (group 2, n=87), 5.5%≤HbAlc<6.0% group (group 3, n=109) and 6.0%≤HbAlc<6.4% group (group 4, n=102). The main study endpoint was 1-year all-cause mortality, and second study endpoints were 30-day mortality and CK-MB peak value.Results The total 1-year all-cause mortality was 13.57% in all patients, and 8.2% in group 1, 11.5% in group 2, 13.8% in grouop 3 and 21.6% in group 4. The comparison in 30-day mortality and CK-MB peak value showed there was no statistical difference among all groups (P>0.05). Cox regression model showed that HbAlc was an independent predictive factor of 1-year mortality (OR=1.2, P<0.05).Conclusion The level of HbAlc at being hospitalizing is a predictive index for 1-year mortality in the nondiabetic patients with AMI, and 1-year mortality will increase when the level of HbAlc increases.