中文摘要：

目的利用血管内超声（IVUS）技术探讨非ST段抬高型急性冠状动脉综合征（NSTE-ACS）患者入院糖化血红蛋白（HbA_（1c））水平与冠状动脉病变特点的关系。方法 118例NSTE-ACS患者按照入院时HbA_（1c）水平以三分位法分为低水平组（HbA_（1c）≤5.6%）、中水平组（HbA_（1c）5.7%~6.4%）、高水平组（HbA_（1c）≥6.5%）,对罪犯病变进行IVUS检查。结果与HbA_（1c）低水平组及中水平组相比,高水平组患者平均体重指数较高,糖尿病史、血脂异常病史比例更高。HbA_（1c）高水平组患者三支病变（52.4%比16.7%比25.0%）、弥漫性病变（61.9%比11.1%比15.0%）较低水平组及中水平组更为多见;但单支病变（19.0%比58.3%比45.0%）、局限病变（14.3%比61.1%比60.0%）较低水平组及中水平组更为少见,差异均有统计学意义（均P〈0.01）。IVUS检查结果显示,HbA_（1c）高水平组患者最小管腔面积[（2.81±0.61）mm~2比（3.50±0.47）mm~2比（3.53±0.53）mm~2]较低水平组以及中水平组更小,斑块负荷[（86.83±3.93）%比（75.59±3.48）%比（75.15±4.93）%]、重构指数[（1.34±0.95）比（0.90±0.19）比（1.12±0.11）]较低水平组以及中水平组更高,软斑块（47.6%比22.2%比30.0%）、破裂斑块（52.4%比16.7%比45.0%）较低水平组以及中水平组更为常见,纤维斑块（9.5%比30.6%比20.0%）、混合斑块（21.4%比33.3%比35.0%）较低水平组以及中水平组更为少见,差异均有统计学意义（均P〈0.01）。结论入院HbA_（1c）水平与NSTE-ACS患者冠状动脉病变的易损性有关。

英文摘要：

Objective To explore the association between glycated hemoglobin （HbA1c） level at admission and coronary plaque characteristics under intravenous ultrasound （IVUS） study in patients with non-ST-elevation acute coronary syndrome （NSTE-ACS）. Methods 118 patients with NSTE-ACS were divided into the low（HbA1c ≤ 5.6%）, medium（HbA1c 5.7%-6.4%）and high（HbA1c ≥ 6.5%）level groups based on admission HbA1c. IVUS was performed in all target lesions. Results As compared with the other two groups, patients with high level HbA1c had higher mean body weight index, higher co-morbidities of diabetes mellitus, dyslipidemia and non-ST-elevation acute myocardial infarction.The high HbA1c level group had more diffuse coronary atherosclerosis ,increased plaque burden and higher rates of positive remodeling, soft plaque and plaque rupture. Conculsions The HbAlc level of admission is associated with plaque vulnerability in NSTE-ACS patients.