高血糖对老年急性心肌梗死患者血B型脑钠肽、超敏C反应蛋白和心室重构的影响  

Impact of hyperglycemia on hypersensitive C-reaction protein, B-type natriuretic peptide and ventricular remodeling of elder patients with acute myocardial infarction

作　　者：卢维晟[1] 刘芳[1] 张江蓉[1] 袁惠敏[1] 王一尘[1] 

机构地区：[1]上海交通大学医学院附属新华医院老年科,200092

出　　处：《中国综合临床》2014年第11期1156-1158,共3页Clinical Medicine of China

摘　　要：目的 探讨高血糖对老年急性心肌梗死（AMI）患者超敏C反应蛋白（hs-CRP）、B型脑钠肽（BNP）和心室重构的影响.方法 120例老年AMI患者,根据入院血糖水平分为两组,高血糖组60例（入院时血糖≥7.8 mmol/L）和非高血糖组60例（入院时血糖＜7.8 mmol/L）.检测两组患者入院时血糖、血清hs-CRP和BNP,心脏超声检测入院时和2周后左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）和室壁运动积分（WMS）的指标.结果 高血糖组入院时血糖、BNP和hs-CRP分别为（9.6±0.6）mmol/L、（1 750.6±677.1）ng/L、（56.1 ±38.6） ng/L,显著高于非高血糖组（5.7±0.5）mmol/L、（497.2±450.3）ng/L、（36.3±26.2）ng/L（t值分别为38.7、11.9、3.3,P均＜0.01）;高血糖组患者心脏超声指标LVEF、LVEDD、LVESD和WMS治疗前、后比较差异均无统计学意义（P均＞0.05）.非高血糖组患者治疗前、后LVEF[（52.51±10.01）％与（56.4±9.5）％]、LVEDD[（50.2±5.6） mm与（53.0±5.2） mm]、LVESD[（36.8±6.2）mm与（41.0±6.2） mm]和WMS[（2.1±0.7）分与（2.9±1.0）分]均有统计学意义（t值分别为2.049、2.836、3.814、2.086,P均＜0.05）.结论 高血糖可导致hs-CRP、BNP升高,对AMI老年患者的心室重构产生影响,但更多机制需要深入研究.Objective To explore the impact of hyperglycemia on Hypersensitive C-reaction protein （hsCRP）,B-type natriuretic peptide（BNP） and ventricular remodeling in elder patients with acute myocardial infarction（AMI）.Methods One hundred and twenty elder patients with AMI are divided into hyperglycemia group（blood sugar in admission ＞ 7.8 mmol/L） and non-glycemia group（blood sugar in admission ≤7.8 mmol/L）.The levels of blood sugar in admission,hsCRP,BNP were detected.LVEF,LVEDD,LVESD,WMS were observed by cardiac echo in admission and two weeks after therapy.Results The blood sugar in admission,hsCRP and BNP of the patients in hyperglycemia group were （9.6 ± 0.6） mmol/L,（1 750.6 ±677.1） ng/L,（56.1 ±38.6） ng/L,higher than those in non-glycemia group （t =38.679 and P =0.000; t =11.941 and P =0.000; t =3.288 and P ＜0.01,respectively）.LVEF,LVEDD,LVESD and WMS of patients in hyperglycemia group didn＇t show statistical significance before and after therapy.However,there were significant in hyperglycemia group （t =2.049 and P =0.043,t =2.836 and P =0.005,t =3.814 and P =0.000,t =2.086 and P =0.039,respectively）.Conclusion Hyperglycemia can reduce the increase of hsCRP and BNP,which has an impact on hsCRP,BNP and ventricular remodeling in elder patients with acute myocardial infarction,but the mechanism need to further research.

关 键 词：急性心肌梗死 高血糖 老年人 超敏C反应蛋白 B型脑钠肽 心室重构 

分 类 号：R542.22[医药卫生—心血管疾病]