入院时血糖水平和急性冠脉综合征患者行经皮冠状动脉介入术预后的相关性研究  

Correlation between admission glucose level and prognosis in patients with acute coronary syndrome after PCI

作　　者：唐雪正[1] 黄骁 唐发宽[1] 陈鹏飞 Tang Xuezheng;Huang Xiao;Tang Fakuan;Chen Pengfei(Department of Cardiovascular Medicine,Eighth Medical Center of Chinese PLA General Hospital,Beijing 100091,China;不详)

机构地区：[1]解放军总医院第八医学中心心血管内科,北京100091 [2]解放军总医院心血管学部第八医学中心心血管内科,北京100091

出　　处：《中国循证心血管医学杂志》2021年第6期730-733,741,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨入院时的血糖水平(ABG)对急性冠脉综合征(ACS)患者行经皮冠状动脉成形术(PCI)在院和术后半年的预后影响。方法连续入选2015年1月至2018年12月于解放军总医院第八医学中心心血管内科住院ACS患者750例,入院2 h内测定ABG,并分为3组(正常血糖组,ABG<7.8 mmol/L,正常高值组,7.8 mmol/L≤ABG<11.1 mmol/L和高血糖组,ABG≥11.0 mmol/L)。收集其基本临床资料,手术相关数据,在院和术后半年的并发症情况。结果相较于正常血糖组和正常高值组,高血糖组患者PCI后在院死亡率(6.8%vs.3.1%vs.0.7%,P<0.01)和术后6个月死亡率(13.7%vs.4.7%vs.2.4%,P<0.01)均明显升高。经过多因素Logistic回归分析,ABG≥11.1 mmol/L为预测ACS患者行PCI后在院(OR=3.348,95%CI:1.200~9.338,P<0.05)和术后6月死亡率(OR=3.993,95%CI:1.409~11.316,P<0.01)的独立危险因素。结论入院时的高血糖状态会增加ACS患者行PCI短期死亡风险,是预测其在院和术后6月死亡率的独立危险因素。Objective To investigate the influence of admission blood glucose level(ABG)on prognosis in patients with acute coronary syndrome(ACS)undergone PCI during hospitalization and after PCI for 6 months.Methods ACS patients(n=750)were chosen from Department of Cardiovascular Medicine in the Eighth Medical Center of Chinese PLA General Hospital from Jan.2015 to Dec.2018.Within 2 h after hospitalization,the level of ABG was detected and all patients were divided into normal ABG group(ABG<7.8 mmol/L),high-normal ABG group(7.8 mmol/L≤ABG<11.1 mmol/L)and high ABG group(ABG≥11.0 mmol/L).The clinical materials and data related to PCI were collected,and complications during hospitalization and after PCI for 6 months were observed.Results Compared withnormal ABG group and high-normal ABG group,the in-hospital mortality(6.8%vs.3.1%vs.0.7%,P<0.01)and mortality after PCI for 6 months(13.7%vs.4.7%vs.2.4%,P<0.01)increased significantly in high ABG group.The results of multi-factor Logistic regression analysis showed than ABG≥11.1 mmol/L was an independent risk factor for predicting in-hospital mortality(OR=3.348,95%CI:1.200~9.338,P<0.05)and mortality after PCI for 6 months(OR=3.993,95%CI:1.409~11.316,P<0.01).Conclusion Higher ABG will raise short-term death risk in ACS patients undergone PCI,and ABG is an independent risk factor for predicting in-hospital mortality and mortality after PCI for 6 months.

关 键 词：经皮冠状动脉介入术 急性冠脉综合征 血糖 预后 

分 类 号：R816.2[医药卫生—放射医学]