心力衰竭患者血糖升高的临床意义探讨  

Clinical significance of elevated blood glucose in patients with heart failure

作　　者：容永怡 陈林祥[2] 余泽洪[2] 黄振文[2] 

机构地区：[1]江门市杜阮人民医院,广东江门529050 [2]江门市人民医院江门市心血管病研究所,广东江门529050

出　　处：《岭南心血管病杂志》2012年第2期158-159,177,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨非糖尿病心脏病合并心力衰竭患者入院时空腹血糖浓度升高的临床意义。方法选择非糖尿病冠状动脉粥样硬化性心脏病(冠心病)、高血压心脏病合并心力衰竭患者392例为研究对象。入院时常规测入选患者的空腹血糖浓度,比较不同血糖浓度组患者的心功能分级和住院病死率。结果在这392例心力衰竭患者中,血糖浓度正常者达162例(41.3%),糖调节受损122例(29.4%),高血糖108例(26.0%)。高血糖组心功能Ⅲ～Ⅳ级患者占76.9%,糖调节受损组占65.6%,与血糖正常组(22.8%)比较,差异有统计学意义(P<0.05)。在院内死亡的17例中,血糖正常组2例(11.8%),糖调节受损组6例(35.3%),高血糖组9例(52.9%);3组住院病死率比较,差异有统计学意义(P<0.05)。结论非糖尿病心脏病合并心力衰竭患者血糖越高,心力衰竭严重程度越高,住院病死率也越高,提示糖代谢紊乱可能是心力衰竭的发生、发展及预后的影响因素。Objectives To evaluate the clinical significance of elevated blood glucose in patients with non-diabetic cardiopathy complicated by heart failure.Methods Fasting blood glucose of 392 patients with non-diabetic coronary heart disease（CHD） or hypertensive heart disease（HHD） complicated by heart failure was regularly tested on admission day.Heat functional grades and case-fatality rate in different groups classified by blood glucose concentration were compared.Results Of all the 392 patients,there were 162（41.3%） patients with normal blood glucose concentration,122（29.4%） with impaired glucose regulation and 108（26.0%） with hyperglycemia.76.9% of the patients in hyperglycemia group were found with heart functional grade III-IV,65.6% in impaired glucose regulation group,which was of statistical significance comparing with 22.8% in normal blood glucose concentration group（P0.05）.In 17 dead cases,2 cases（11.8%） were in normal blood glucose concentration group,6 cases（35.3%） were in impaired glucose regulation group and 9 cases（52.9%） were in hyperglycemia group.Difference of case-fatality rate among the 3 groups was of statistical significance（P0.05）.Conclusions The higher blood glucose concentration is in patients with non-diabetic cardiopathy complicated by heart failure,heart failure is more severe and case-fatality rate is higher,which indicates that glucose metabolic disorder can affect the occurrence,progress and prognosis of heart failure.

关 键 词：心力衰竭 空腹血糖 冠状动脉疾病 心功能 病死率 

分 类 号：R541.6[医药卫生—心血管疾病]