无糖尿病史心肌梗死患者血糖应激性升高对心肌功能及预后的影响  

Effect of Stressed Hyperglycemia on Myocardial Function and Prognosis in Patients with Myocardial Infarction and without History of Diabetes

作　　者：唐艺加[1] 

机构地区：[1]四川省人民医院心内科,成都610072

出　　处：《解放军预防医学杂志》2016年第2期169-171,共3页Journal of Preventive Medicine of Chinese People's Liberation Army

摘　　要：目的分析无糖尿病史心肌梗死患者血糖应激性升高对心肌功能及预后的影响,为心肌梗死的临床诊治和改善预后提供参考依据。方法以某医院2013年2月-2015年5月收治的120例无糖尿病史心肌梗死患者为对象,根据急诊血糖检查结果将患者分为血糖升高组(78例,随机血糖≥11.1 mmol/L)和血糖正常组(42例,随机血糖<11.1mmol/L),比较2组患者肌钙蛋白Ⅰ(c TnⅠ)、肌酸激酶同工酶峰值(CK峰值)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室舒张末期容积(LVEDV)及不良心血管事件发生率。结果血糖升高组LVEF、c TnⅠ、CK峰值分别为(55.5±6.8)%、(3.78±0.51)μg/L、(185.0±14.7)U/L,血糖正常组分别为(68.5±5.9)%、(0.73±0.15)μg/L、(113.2±85.3)U/L,2组比较差异有统计学意义(P<0.01)。血糖升高组严重心律失常、心功能不全、心源性猝死发生率分别为25.6%、44.9%、14.1%,显著高于正常组(分别为9.5%、23.8%、2.4%),差异有统计学意义(P<0.05)。结论无糖尿病史心肌梗死患者血糖应激性升高对其心肌功能造成不良影响,增加不良心血管事件发生几率,预后较差。Objective To analyze the effect of stressed hyperglycemia on myocardial function and prognosis in patients with myocardial infarction and without history of diabetes,so as to provide reference evidence for clinical diagnosis and treatment and prognosis improvement. Methods A total of 120 patients with myocardial infarction and without history of diabetes mellitus treated in a hospital from February 2013 to May 2015 were taken as the research subjects. According to the results of blood glucose in emergency,the patients were divided into the hyperglycemia group（ random blood glucose 11. 1mmol / L and above,78 cases） and the normal group（ under 11. 1mmol / L,42 cases）. The troponin I（ c Tn I）,creatine kinase isoenzyme peak value（ CK peak value）,left ventricular ejection fraction（ LVEF）,left ventricular end diastolic dimension（ LVEDD）,left ventricular end- diastolic volume（ LVEDV） and the incidence of adverse cardiovascular events in the two groups were detected and compared. Results The peak values of LVEF,c Tn I and CK were（ 55. 5 ± 6. 8） %,（ 3. 78 ± 0. 51） μg / L and（ 185. 0 ± 14. 7） U / L respectively in hyperglycemia group,and had significant differences compared with those in normal group 〔（ 68. 5 ± 5.9） %,（ 0. 73 ± 0. 15） μg / L,（ 113. 2 ± 85. 3） U / L〕（ P〈0. 01）. The incidence rates of severe arrhythmia,cardiac insufficiency,sudden cardiac death in hyperglycemia group were 25. 6%,44. 9% and 14. 1%,respectively,and significantly higher than those in normal group（ 9. 5%,23. 8%,2. 4%）（ P〈0. 05）. Conclusion Stressed hyperglycemia in patients with myocardial infarction and without history of diabetes mellitus has adverse effect on myocardial function,increases the risk of adverse cardiovascular events,and has poor prognosis.

关 键 词：无糖尿病史 心肌梗死 血糖应激性升高 心肌功能 预后 

分 类 号：R587.1[医药卫生—内分泌] R542.22[医药卫生—内科学]