急性心肌梗死患者血糖波动与冠脉病变程度的相关性研究  

Correlation analysis between blood glucose fluctuation and coronary artery lesions on the patients with acute myocardial infarction

作　　者：张弓[1] 程国杰[1] 张银[1] 胡硕强[1] 佟子川[1] 曹树军[1] 

机构地区：[1]首都医科大学大兴医院心内科,北京市102600

出　　处：《中国心血管病研究》2017年第6期550-554,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨急性心肌梗死患者血糖波动与冠脉病变程度的关系.方法 选择2012年2月至2015年12月在我院心内科住院的急性ST段抬高型心肌梗死（STEMI）患者156例为研究对象,采用美敦力动态血糖监测系统（CGMS,Minimed）对入选患者进行连续血糖监测,同时行冠脉造影检查,对冠脉病变进行SYNTAX评分.根据是否合并糖尿病将所有患者分为糖尿病组（A组,59例）和非糖尿病组（B组,97例）,比较两组患者冠脉病变、血糖波动指标的差异,分析血糖波动与冠脉病变之间的关系.根据平均血糖波动幅度（MAGE）正常与否将入选者分为MAGE〉3.9 mmol/L组41例和MAGE≤3.9 mmol/L组1 15例,比较两组患者的冠脉病变程度.结果 A组患者平均血糖（MBG）和血糖标准差（SDBG）明显高于B组[（9.7±0.7）mmol/L比（5.5±2.1）mmol/L,（2.5±1.2）mmol/L比（1.2±0.8）mmol/L,P〈0.01];A组患者MAGE明显高于B组[（3.8±1.2）mmol/L比（2.6±1.3）mmol/L,P〈0.01];A组患者冠脉SYNTAX评分明显高于B组（17.3±4.7比13.5±3.3,P〈0.01）.MAGE〉3.9 mmol/L组患者冠脉SYNTAX评分明显高于MAGE≤3.9 mmol/L组（18.9±3.1比14.7±4.5,P 〈0.01）.相关性分析显示,冠脉SYNTAX评分与MAGE、MBG和HBA1c之间呈正相关（r=0.854,0.372,0.468,P〈0.05）.结论 急性心肌梗死患者血糖波动幅度与冠脉病变程度之间有明显相关性,血糖波动幅度越大,冠脉病变程度越重.Objective To explore the correlation between blood glucose fluctuation and coronary artery lesions on the patients with acute myocardial infarction.Methods 156 patients who hospitalized because of acute ST segment elevation myocardial infarction（STEMI） in Department of Cardiology,Daxing Hospital of Capital Medical University were selected from Feb 2012 to Dec 2015.The patients were monitored glucose using Medtronic continuous glucose monitoring system（CGMS,Minimed） for 72 hours.All patients underwent coronary angiography and coronary lesions SYNTAX score was calculated.The patients were divided into A group（STEMI with DM） and B group （STEMI without DM） based on whether accompanied DM or not.The patients also were divided into MAGE〉3.9 mmol/L group and MAGE ≤3.9 mmol/L group according to the MAGE was normal or not.Correlation between blood glucose excursion and coronary artery lesions were analyzed.Results The mean blood glucose （MBG） and standard deviation of blood glucose（SDBG） of group A was significantly higher than group B [（9.7± 0.7）mmol/L vs （5.5±2.1）mmol/L,（2.5±1.2）mmol/L vs （1.2±0.8）mmol/L,P〈0.01].The mean amplitude of glycemic excursions（MAGE） of group A was significantly higher than that of group B[（3.8±l.2）mmol/L vs （2.6±1.3）mmol/L,P〈0.01].The.SYNTAX score of group A was significantly higher than group B （17.3±4.7 vs 13.5±3.3,P〈0.01）.The SYNTAX score of the patients with MAGE〉3.9 mmol/L was also higher than that of the patients with MAGE≤3.9 mmol/L （18.9±3.1 vs 14.7±4.5,P〈0.01）.The SYNTAX score was positively correlated with MAGE,MBG and HBA1c （r=0.854,0.372,0.468,P〈0.01）.Conclusion There is significant positive correlation between glucose excursion and severity of coronary artery lesions in patients with acute myocardial infarction.

关 键 词：急性心肌梗死 血糖波动 冠脉病变 

分 类 号：R542.22[医药卫生—心血管疾病]