冠心病患者糖代谢的变化和预后的相关性研究.doc

糖代谢冠心病患者的变化预后的罗瑞萍 蒋利 徐颖杰 岳静雯 沈泽宁 摘要 目的本研究对糖代谢正常的冠心病患者进行随访，糖代谢及其对预后的影响。方法例糖代谢正常的冠心病患者在住院期间及出院后进行简化检查心血管事件的发生率。结果随访期间新发IGT）、空腹血糖受损（IFG）和IGT＋IFG），占％，发生率为/100人年新发DM）45例16.07％，发生率为8./100人NGM ）203 例，占 72. ％。NG组有4 例（23.1％）发生，组有1例（4％）发生DM组有 例（4％）发生IGR组DM组的发生率均较正常组高，差异有显著性。结论住院期间糖代谢正常的冠心病患者在病程中有的患者出现糖代谢异常，其预后比糖代谢正常者差。 关键词冠 糖尿病 糖代谢异常 预后 Influence Glucose Metabolism Change on the Prognosis in Patients Diagnosed Coronary Artery Disease with Normal Glucose Metabolism Luo Rui-ping, Jiang Li, Xue Yin-jie, Yue Jing-weng, Shen Ze-ning. Division of Cardiology, Shanghai Changning District Center Hospital, Shanghai 200336, China 【Abstract】 Objective To investigate the late glucose metabolism change and its impact on long-term outcomes of patients with coronary artery disease (CAD) and normal glucose metabolism(NGM). Methods Simplified oral glucose tolerance test(OGTT) was performed in 280 consecutive patients diagnosed CAD with NGM in our hospital before the discharge and every 6 months during the follow-up period. To record and compare the major adverse cardiac events (MACE) (include recurrent myocardial infarction, revascularization and cardiac death) in different groups. Results Mean follow-up duration was 22.70?3.42 months)(ranged from 6 to 61months). Of 280 patients, 45 patients developed diabetes(16.07%) (DM group), 32 patients developed impaired glucose regulation（IGR）（including impaired glucose tolerance(IGT) 、impaired fasting glucose(IFG) and IGT+IFG）(11.42%)，and 203 patients kept NGM (72.50%)（NGM group）. With MACE occurred, there were 21 patients in DM group（4％）, 1 patients in IGR group （4％）47 patients in NGM group（23.1％）. Compared with NGM group, DM group and IGR group had higher incidence rate of MACE(P=0.0014 and P=0.0351, respectively). Logistic regression analysis showed that age, male, history of myocardial infarction and abnormal glucose metabolism were independent predictors of MACE. Conclusions Many patients diagnosed initially CAD with NGM develop into la