急症高血糖对N端脑钠肽原评价心功能的影响.docVIP

PAGE PAGE 1 急症高血糖对N端脑钠肽原评价心功能的影响 　　【摘要】目的对不同血糖状态下的N端脑钠肽原（NterminalproBNP，NT-proBNP）与组织多普勒（TDI）测定的心功能指数（Tei指数）相关性进行分析，探讨急症高血糖状态对NT-proBNP评价心功能的影响。方法前瞻性纳入广东省人民医院心内科连续收入的急性冠脉综合征患者，根据入院后空腹血糖水平分为急症高血糖组（空腹血糖≥6.1mmol/L）和正常血糖组（空腹血糖2=0.702，回归系数检验t=7.675，P2=0.405，回归系数检验t=4.738，P 　　【关键词】高血糖；应激；急性冠脉综合征；利钠肽，脑；心室功能；超声心动图；组织多普勒；Tei指数 　　InfluenceofacutehyperglycemiaontheassessmentofcardiacfunctionwithN-terminalpro-brainnatriureticpeptideXUELing，FUMing，LUOJian-fang，WANGLing，ZHOUYing-ling，CHENJi-yan.DepartmentofCardiology，GuangdongCardiovascularInstitute，GuangdongAcademyofMedicalSciences，GuangdongProvincialPeople’sHospital，Guangzhou510080，China 　　Correspondingauthor：LUOJian-fang，Email：drxue@ 　　【Abstract】ObjectiveToinvestigatetherelationshipbetweenN-terminalpro-brainnatriureticpeptide（NT-proBNP）andtissueDopplerimaging（TDI）derivedcardiacfunctionindex（Teiindex）inpatientswithacutecoronarysyndromeunderdifferentplasmaglucoselevelsandtoevaluatetheinfluenceofhyperglycemiaontheprecisenessofcardiacfunctionassessmentwithNT-proBNP.MethodsConsecutivepatientswithacutecoronarysyndromeadmittedtothedepartmentofcardiologyinGuangdongGeneralHospitalwereprospectivelyenrolled.Basedontheirplasmafastingglucoselevel，patientsweredividedintohyperglycemiagroup（fastingplasmaglucose≥6.1mmol/L）andeuglycemiagroup（fastingplasmaglucose6.1mmol/L）.AllthepatientsunderwenttransthoracicechocardiagraphyandtissueDopplerimaging（TDI）investigations.Bloodsampleswereobtainedwithin24hoursofhospitalizationformeasurmentofNT-proBNPlevel.RelationshipbetweenTDI-TeiindexandthelevelofNT-proBNPinthetwogroupswereanalyzedrespectively.ResultsTheTDI-Teiindex，thesystolicindexandthediastolicindexwereallsignificanthigherinthehyperglycemiagroup（n=27）thanthoseintheeuglycemiagroup（n=35）（0.68±0.14）vs.（0.61±0.10），P=0.03；（0.29±0.07）vs.（0.26±0.05），P=0.045；（0.38±0.08）vs.（0.35±0.050，P=0.03，respectively.Inbothgroups，TDI-TeiandlnNT-proBNPshowedsignificantlinearregression.Inthehyperglycemiagroup，TDI-Tei=0.175+0.068lnNT-proBNP，R2=0.702，P0.01.Intheeuglyc