无糖尿病史的急性冠脉综合征患者出院前和随访期糖代谢状态一致性的研究  

A Study of the Consistence of the Glucometabolic Status in Following-up with before Hospital Discharge in Patients with Acute Coronary Syndrome and without Known Diabetes Mellitus

作　　者：闫明珠[1] 胡大一[1] 刘文玲[1] 刘梅颜[1] 

机构地区：[1]北京大学人民医院心内科,北京100044

出　　处：《中国医药导刊》2006年第3期157-159,共3页Chinese Journal of Medicinal Guide

摘　　要：目的:了解无糖尿病(DM)史的急性冠脉综合征(ACS)患者出院前和随访期糖代谢状态的一致性。方法:2005年6月1日-11月31日,连续入选我院因ACS收入心脏监护病房并行冠状动脉造影检查的符合入选标准(随机血糖<11．1mmol／L,或空腹血糖<7．0mmol／L)的患者99例。出院前(平均住院的4-5d)行简化日服糖耐量试验(OGTT)试验,出院后3-4月再次行OGTT试验,两次OGTT试验间未接受任何降糖药物治疗。对两种糖代谢状态比较,评价二者的一致性。结果:本研究入组人群(n=99)中,将随访期糖代谢状态与出院前结果进行一致性比较,kappa值0.548,P= 0．0000出院前OGTT 2h血糖水平对随访期DM诊断的ROC曲线下面积为0.908,95％CI 0.894-0．984,院前OGTT 2h血糖水平11．13mmol／L对于预测随访期DM的敏感性为93％,特异性为82％。结论:随访期糖代谢状态与出院前诊断具有较好的一致性。ACS患者应出院前常规行OGTT试验,筛查糖代谢异常并加强高血糖的预防和干预。Objective：To compare the consistence of the glucometabolic status in following- up with before hospital discharge. Methods： Patients（n = 99） with ACS, no previous DM and admission blood glucose 〈 11.1mmol/ L and fasting blood glucose 〈 7.0mmol/L in People＇ s hospital were enrolled consecutively from Jun, 2005 to Dec, 2005. An simplified OGTr was performed before hospital discharge and repeated after 3 or 4 months. There was no any therapy between two tests.Results：Kappa analysis showed the glucometabolic status in following - up was consistent with before hospital discharge. 2h plasma glucose before discharge was a predictor of diabetes after 3 months.A plasma glucose cut - off 11.13mmol/L had a sensitivity of 93% and a specificity of 82%. Conclusion： the glucometabolic status in following-up was consistent with the glucometabolic status before hospital discharge. Therefore we should perform routinely oral glucose tolerance test before discharge, find abnormal glucose metabolism and intensify hyperglycemia prevention and intervention in ACS.

关 键 词：急性冠脉综合征 糖代谢异常 口服糖耐量试验 

分 类 号：R541.4[医药卫生—心血管疾病]