糖耐量减低对行早期经皮冠状动脉介入治疗的急性ST段抬高型心肌梗死患者短期预后的影响  

Effect of impaired glucose tolerance on the short-term prognosis of patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention

作　　者：吴苑苑 杨旭明[1] 王利娟 WU Yuan-yuan;YANG Xu-ming;WANG Li-juan(The First Affiliated Hospital,College of Clinical Medicine of Henan University of Science and Technology,Luoyang,Henan 471003,China)

机构地区：[1]河南科技大学临床医学院河南科技大学第一附属医院

出　　处：《岭南心血管病杂志》2019年第5期495-498,共4页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨糖耐量减低(impaired glucose tolerance,IGT)对行早期经皮冠状动脉介入治疗的急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者短期预后的影响。方法选择2014年1月至2017年6月河南科技大学第一附属医院心内科收治的行早期经皮冠状动脉介入治疗的STEMI患者为研究对象。通过糖尿病病史及口服葡萄糖耐量试验(oral glucose tolerance test,OGTT)结果,将入选患者分为血糖正常组(normal plasma glucose group,NGG组)、糖耐量减低组(IGT组),剔除空腹血糖受损及糖尿病患者。主要观察指标为住院期间、术后1年主要不良心血管事件(major adverse cardiovascular events,MACE)发生情况。结果NGG组住院期间、术后1年MACE发生率小于IGT组,差异有统计学意义[15.38%(8/52)vs.30.77%(32/104),P=0.038;21.28%(10/47)vs.40.00%(36/90),P=0.028]。结论对STEMI患者进行OGTT试验,及早地发现糖耐量受损患者,尽早进行血糖管理,可能可以改善患者预后。Objectives To explore the effect of impaired glucose tolerance(IGT)on the short-term prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI)treated with primary percutaneous coronary intervention.Methods From January 2014 to June 2017,STEMI patients admitted to the department of cardiology in the First Affiliated Hospital of Henan University of Science and Technology for primary percutaneous coronary intervention(PCI)were selected as the study subjects.According to the history of diabetes and result of oral glucose tolerance test (OFTT),patients were divided into normal plasma glucose group(NGG group)and impaired glucose tolerance group (IGT group),eliminating the patients with impaired fasting blood glucose and diabetes.The main observation indexes were the occurrence of major adverse cardiovascular events (MACE) during hospitalization and 1 year after PCI.Results The incidence of MACE in NGG group was lower than that in IGT group during hospitalization and 1 year after PCI,the differences were statistically significant[15.38%(8/52)vs.30.77%(32/104),P=0.038;21.28%(10/47)vs.40.00%(36/90),P=0.028].Conclusions It is recommended to conduct OGTT in STEMI patients,in order to find out patients with IGT,and to control their blood glucose as early as possible,thus improve the prognosis of patients.

关 键 词：急性ST段抬高型心肌梗死 血管成形术 经腔 经皮冠状动脉 糖耐量减低 主要不良心血管事件 

分 类 号：R542.22[医药卫生—心血管疾病]