应激性高血糖对急性心肌梗塞患者冠脉病变程度及预后的影响.DOC

作者单位：1.上海中医药大学附属普陀医院老年科，上海，200062；2.普陀医院心内科 通信作者：金惠根，电子信箱：Jinhuigen@ 应激性高血糖对急性心肌梗死患者冠脉病变程度及心功能的影响 丘洪１，李英梅２，汪蔚青２，杨伟２，刘宗军２，方平２，江蓓湖１，金惠根２ 摘要：目的　探讨应激性高血糖对急性心肌梗死患者冠脉病变程度及心功能的影响。方法　对106例急性心肌梗死入院的患者根据空腹或即刻血糖、糖化血清蛋白、糖化血红蛋白指标进行分组，分成血糖正常组（A组，38 例）、应激性高血糖组（B 组，33 例）和糖尿病组（C 组，35例），并对三组患者的血脂指标、C反应蛋白、左室射血分数以及冠脉积分进行对比分析。结果 应激性高血糖组（B 组）和糖尿病组（C 组）与血糖正常组（A 组）相比左室射血分数显著降低，冠脉积分显著增高（P＜0.05），C反应蛋白也显著增高（P＜0.01），B、C 两组无显著差异（P＞0.05）。结论 应激性高血糖可加重冠脉病变程度，使急性心肌梗死患者心功能下降。 关键词：急性心肌梗死；应激性高血糖；心功能 The effect of stress hyperglycemia on the aeteria coronaria affection degree and the cardiac function of acute myocardial infarction patiens Qiu Hong*,Li Ying-mei,Wang Wei-qing,Yang Wei,Liu Zong-jun,Fang Ping,Jiang Bei-Hu,Jin Hui-gen.*Department of geriatrics,Shanghai Putuo Hospital,University of Traditional Chinese Medicine,Shanghai 200062,China Abstract: objective To approach the the effect of stress hyperglycemia on the coronary artery disease and the cardiac function of acute myocardial infarction patiens. Methods A total of 106 acute myocardial infarction patiens were divided into 3 groups according to empty stomach or instantly serum glucose、saccharifying serum protein、glycosylated hemoglobin: euglycemia group (group A,n=38), stress hyperglycemia group (group B,n=33), diabetes group (group C,n=35).And the blood-fat、CRP、EF of left ventricle 、aeteria coronaria integral in hospitalized patients were analyzed among 3 groups. Results The EF of left ventricle of group B and C was lower and the aeteria coronaria integral and CRP was higher than group A(P0.05,p0.01),there was no difference between group B and C(P0.05).Conclusion Stress hyperglycemia may aggravate aeteria coronaria disease and lower the cardiac funtion of acute myocardial infarction patients. x Key words: Acute myocardial infarction；Stress hyperglycemia；Cardiac function 作为冠心病的等危症，糖尿病增加急性心肌梗死（AMI）近期和远期死亡率早已为研究所证实，故是否有糖尿病史被认为是心肌梗死危险评估的常规指标。然而近年来又有研究发现，入院血糖水平无论在有无糖尿病史的患者都是影响AMI病死率的重要危险因素，AMI时出现的应激性高血糖对梗死后心肌所造成的危害也越来越受到人们的重视。本研究旨在探讨应激性高血糖对A