强化降糖治疗对急性心肌梗死高血糖患者心室重构及血清炎性介递质的影响  

Influence of intensive lowing blood glucose therapy on ventricular remodeling and inflammatory mediators in patients with acute myocardial infarction and hyperglycemia

作　　者：李爱焕[1] 薛莉[2] 

机构地区：[1]宁夏医科大学,银川市750004 [2]宁夏医科大学附属医院,银川市750004

出　　处：《临床合理用药杂志》2011年第9期1-2,共2页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的探讨急性心肌梗死（AM I）高血糖患者强化降糖与心室重构及炎性因子分泌的相关性。方法 66例患者分为强化降糖治疗组34例和常规治疗组32例,强化降糖治疗组血糖控制在4.4~7.8mmol/L,常规治疗组血糖控制在7.8~11.1mmol/L。观察2组血清超敏C反应蛋白（hsCRP）、心脏超声测量左室舒张末内径（LVEDD）、左室收缩末内径（LVESD）、左室射血分数（LVEF）及室壁运动记分（WMS）情况。结果治疗后强化降糖治疗组LVEF、LVEDD、WMS改善情况均优于常规治疗组,血清hsCRP水平低于常规治疗组,差异有统计学意义（P〈0.05）,但LVESD比较差异无统计学意义（P〉0.05）。血糖水平与治疗后的hsCRP、LVEF、LVEDD及LVESD均呈直线相关,相关系数r分别为0.373、0.389、0.397、0.048,差异均有统计学意义（P〈0.01）。结论强化降糖治疗可明显改善AM I高血糖患者的心室重构及心功能,其机制可能与降低AM I的炎性递质有关。Objective To explore the relationship of intensive lowing blood glucose with inflammatory mediators and ventricular remodeing in patients with acute myocardial infarction （AMI） and hyperglycemia. Methods 66 cases were divided into intensive lowing blood glucose group of 34 and conventional treatment group of 32. The blood glucose of intensive lowing blood glucose group was controled in 4.4- 7.8mmol/L,while that of the conventional treatment group was controled in 7.8 11. lmmoL/L. The hsCRP, LVEDD, LVESD, LVEF, WMS of 2 groups were observed. Results After treatment, the improvement of LVEF, LVEDD and WMS of the intensive lowing blood glucose group were respectively better than those of the conventional treatment group, while the level of hsCRP was lower, and all the differences were statistically significant（ P 〈 0.05 ）, but there was no statistical significance between LVESD of 2 groups（P 〉0.05 ）. The level of blood glucose were all linearly correlated with hsCRP, LVEF ,LVEDD and LVESD ,and r values were 0. 373,0. 389,0. 397,0. 048 respectively, and the differences were statistically significant （ P〈 0.01 ）. Conclusion Intensive blood glucose therapy can obviously improve ventricular re modeling and heart funtion in patients with AMI and hyperglycemia, with a probably mechanism of reducing the inflammatory mediators of AMI.

关 键 词：心肌梗死 急性 心室重构 高血糖 炎性因子 

分 类 号：R542.22[医药卫生—心血管疾病]