血糖水平对急性冠脉综合征患者近期预后的影响  

Effects of level of blood glucose on the recent prognosis of acute coronary syndrome

作　　者：朱蕾[1] 王少媛[1] 徐进[1] 孟海燕[2] 郭志军[1] 

机构地区：[1]山东省交通医院内分泌科,济南250031 [2]山东省交通医院心内科,济南250031

出　　处：《中国糖尿病杂志》2006年第1期23-25,共3页Chinese Journal of Diabetes

摘　　要：目的探讨血糖水平对急性冠脉综合征（ACS）近期预后的影响机制及处理。方法对366例急性冠脉综合征患者，根据其清晨血糖水平分为正常、应激性高血糖（SHG）、糖尿病（DM）3个组，再按照血糖水平≤6．1mmol／L、6．2～10．0mmol／L、≥10．0mmol／L分为Q1、Q2、Q33个层。对所有资料进行回顾性分析。结果366例ACS合并SHG者126人，其中发生急性心肌梗死（AMI）48例、左室功能不全（LVF）17例、严重心律失常11例、心原性猝死（CD）1例。ACS伴有DM者88人，发生AMI46例、LVF22例、恶性心律失常16例、CD7例。血糖正常组152人，发生AMI12例、LVF7例，恶性心律失常3例、CD0例。结论无论DM患者还是应激性高血糖患者血糖升高均使ACS近期不良预后发生率增加，临床应加强对ACS患者的血糖控制。Objective To explore effects of level of blood sugar on recent prognosis of acute coronary syndrome. Methods 366 cases with acute coronary syndrome were divided into 3 groups： normal group, stress hyperglycaemia group（SHG） and diabetes mellitus group（DM）. Each group was stratified according to levels of fasting blood glucose（Q1 ：≤6.1 mmol/L, Q2 ： 6.2-10.0 mmol/L, Q3 ≥10.0 mmol/L）. Results Of 126 cases with SHG, 48 cases were complicated by AMI; 17, by LVF; 11, by severe arrhythmia; 1, by cardiogenic sudden death. Of 88 cases with DM, 46 cases were complicated by AMI; 22, by LVF; 16, by severe arrhythmia; 7, by cardiogenic sudden death. Of 152 cases with normal glucose, 12 cases complicate AMI, 7 cases complicate LVF, 3 cases complicate malignant arrhythmia, 0 case complicates cardiogenic sudden death. Conclusions With rising of level of blood glucose in patients with DM or SHG, the incidence rate of ill prognosis is increased, and hyperglycemia of patients with acute coronary syndrome should be strictly controlled.

关 键 词：急性冠脉综合征 高血糖症 应激 预后 

分 类 号：R541.4[医药卫生—心血管疾病] R587.1[医药卫生—内科学]