应激性高血糖对STEMI患者内皮功能及炎症反应的影响分析  

Influence of stress hyperglycemia on endothelial function and inflammation in patients with ST-segment elevation myocardial infarction

作　　者：徐文静 杨鸣宇[1] 何航宇 Xu Wenjing;Yang Mingyu;He Hangyu(Department of Cardiology,Huazhou people’s Hospital,Guangdong Province,Huanzhou 525100,China)

机构地区：[1]广东省化州市人民医院心血管内科,广东广州525100

出　　处：《中华卫生应急电子杂志》2021年第3期141-145,共5页Chinese Journal of Hygiene Rescue(Electronic Edition)

摘　　要：目的分析应激性高血糖对ST段抬高型心肌梗死(ST-elevation myocardial infarction, STEMI)患者内皮功能及炎症反应的影响效果。方法回顾性分析广东省化州市人民医院心血管内科2019年1月至2020年1月收治的100例STEMI患者临床资料,其中男性58例,女性42例;年龄40岁~72岁,平均(58.64±4.36)岁。依据有无应激性高血糖分为无应激性高血糖组(70例)和应激性高血糖组(30例),比较两组内皮功能(血管内皮生长因子、内皮细胞特异性分子-1)、炎症反应(超敏C反应蛋白、白细胞介素-1β)、近期主要心血管不良事件发生率。利用Spearman相关性分析法对应激性高血糖、内皮功能、炎症反应、近期主要心血管不良事件发生率的相关性进行检验。结果无应激性高血糖组血管内皮生长因子为(99.89±10.41)ng/L、内皮细胞特异性分子-1为(1.00±0.10)ng/mL、超敏C反应蛋白为(5.24±1.01)mg/L、白细胞介素-1β为(20.20±5.34)ng/L、近期主要心血管不良事件发生率4.29%,与应激性高血糖组[分别为(107.64±12.34)ng/L、(1.15±0.12)ng/mL、(9.37±1.21)mg/L、(27.11±4.89)ng/L、13.33%]比较,差异有统计学意义(P均<0.05)。Spearman相关性分析结果显示,应激性高血糖与血管内皮生长因子、内皮细胞特异性分子-1、超敏C反应蛋白、白细胞介素-1β、近期主要心血管不良事件发生率均呈正相关性(r=0.48、0.52、0.55、0.54、0.43,P<0.05)。结论应激性高血糖会导致STEMI患者内皮功能损伤,诱发炎症反应并与近期主要心血管不良事件发生率有关,需要引起临床足够的重视。Objective To analyze the effect of stress hyperglycemia on endothelial function and inflammatory response in patients with ST elevation myocardial infarction(STEMI). Methods The clinical data of 100 patients with STEMI from January 2019 to January 2020 in Department of Cardiology, Huazhou people’s Hospital of Guangdong Province were retrospectively analyzed, including 58 males and 42 females;The average age was(58.64±4.36) years(range, 40-72 years). They were divided into non stress hyperglycemia group(70 cases) and stress hyperglycemia group(30 cases) according to the presence or absence of stress hyperglycemia β). The incidence of recent major adverse cardiovascular events. Spearman correlation analysis was used to test the correlation of stress hyperglycemia, endothelial function, inflammatory response and recent major cardiovascular adverse events. Results In non stress hyperglycemia group, VEGF was(99.89±10.41) ng/L, endothelial cell specific molecule-1 was(1.00±0.10) ng/ml, high-sensitivity C-reactive protein was(5.24±1.01) mg/L and interleukin-1 was(1.00±0.10) ng/ml β Compared with stress hyperglycemia group(107.64±12.34) ng/L,(1.15±0.12) ng/ml,(9.37±1.21) mg/L,(27.11±4.89) ng/L and 13.33%, the difference was statistically significant(P<0.05). Spearman correlation analysis showed that stress hyperglycemia was associated with vascular endothelial growth factor, endothelial cell specific molecule-1, high-sensitivity C-reactive protein and interleukin-1 β、 The incidence of recent major adverse cardiovascular events were positively correlated(r=0.48, 0.52, 0.55, 0.54, 0.43, P<0.05). Conclusion Stress hyperglycemia can lead to endothelial dysfunction in patients with STEMI, induce inflammatory response, and is related to the incidence of major cardiovascular adverse events in the near future, which needs to be paid enough attention in clinic.

关 键 词：ST段抬高型心肌梗死 应激性高血糖 内皮功能 炎症反应 

分 类 号：R542.22[医药卫生—心血管疾病]