急性冠脉综合征糖代谢异常与冠脉病变程度和近期预后的关系  

Effect of abnormal glucose metabolism on severity of coronary artery disease and short-term outcome in patients with acute coronary syndrome

作　　者：王寅[1] 岳静雯[1] 徐颖杰[1] 蒋利[1] 

机构地区：[1]上海市长宁区中心医院心内科,200336

出　　处：《国际心血管病杂志》2012年第3期175-177,共3页International Journal of Cardiovascular Disease

基　　金：上海市卫生局课题(054111)

摘　　要：目的:探讨急性冠脉综合征(ACS)患者的糖代谢异常与冠脉病变程度和近期预后的相关性。方法:入选ACS并行冠脉造影患者450例,对其冠脉病变进行Gensini评分。根据糖尿病病史和口服糖耐量试验结果分为4组:血糖正常组140例;空腹血糖受损(IFG)组90例;糖耐量受损(IGT)组95例;糖尿病(DM)组125例。观察1个月内各组临床事件发生情况。结果:IGT组和DM组的Gensini评分(63.63±29.43和65.63±28.41)显著高于血糖正常组(47.76±26.54),但IFG组(50.34±27.43)与血糖正常组无差异。口服糖耐量试验2h血糖水平与Gensini评分正相关(r=0.367,P=0.046)。与血糖正常组相比,DM组和IGT组的临床事件(34.3%对60.8%和64.2%,P均<0.01)和全因死亡发生率(6.43%对15.2%和15.78%,P均<0.05)显著增高,但与IFG组无差异。结论:与DM相似,ACS患者合并IGT可能与冠脉病变程度有关,且近期预后较差。Objective： To investigate the relationship between abnormal glucose metabolism and severity of coronary artery disease and short-term outcome in patients with acute coronary syndrome （ACS）. Methods：A total of 450 consecutive patients with ACS underwent coronary angiography were included. The severity of coronary artery lesions was graded using Gensini score system. Among 450 patients, 140 patients had normal plasma glucose level （Control group）, 90 patients had impaired fasting glucose （IFG group）, 95 patients had impaired glucose tolerance （IGT group）, and 125 patients had diabetes mellitus （DM group）. One-month event rate was recorded. Results： Gensini scores were significantly higher in IGT and DM groups than in control group （63.63 ± 29.43 and 65.63 ± 28.41 vs. 47.76± 26.54, P〈0.01, respectively）. There was no significant statistical significance in Gensini scores between control group and IFO group（50.34 ± 27.43）. Two hour postprandial plasma glucose level was weakly related to Gensini scores （R = 0. 367,P = 0. 046）. The rates of clinical events （34.3%vs. 60.8% and 64.2%） （all P〈0.01） and all-cause death （6.43% vs. 15.2% and 15.78%） （all P〈0.05） were significantly higher in DM and IGT groups than in control group, but there was no significant difference between IFG and control groups. Conclusion： In ACS patients, those with DM or impaired glucose tolerance were associated with more severe coronary artery disease and poor short-term prognosis.

关 键 词：急性冠状动脉综合征 空腹血糖受损 糖耐量受损 GENSINI评分 预后 

分 类 号：R541.4[医药卫生—心血管疾病]