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目的探讨急性冠脉综合征患者的预后与血糖之间的关系。方法对149例住院并有完整病例的急性冠脉综合征患者做标准75 g口服葡萄糖耐量试验,根据血糖水平依次分为血糖正常组、空腹血糖异常组、餐后血糖增高组、糖尿病组。利用心电图和心脏超声检测各组中的心肌梗死及心肌缺血范围、心衰的发生率以及住院期间的死亡率。结果血糖正常组及空腹血糖异常组心肌梗死及心肌缺血范围差别不显著,而餐后血糖增高组及糖尿病组心肌梗死及心肌缺血范围明显大于前两组(P<0.05),但后二者差别不显著(P>0.05)。血糖正常组及空腹血糖异常组心衰的检出率基本相同,餐后高血糖组心衰检出率高于前二组,但差别不显著(P>0.05),糖尿病组心衰检出率为65.2%,显著高于前三组(P<0.01)。住院期间糖尿病组共有5例死亡,占7.1%,余各组死亡率为0。以上各种异常检出率在性别间差别均不显著(P>0.05)。结论急性冠脉综合征患者心肌梗死及心肌缺血范围,心衰检出率与其血糖水平密切相关,餐后高血糖及糖尿病患者不良事件发生率明显增加。
Objective To investigate the relationship between prognosis and blood glucose in patients with acute coronary syndrome. Methods A total of 149 patients with acute coronary syndromes who were hospitalized and had complete cases were given standard 75 g oral glucose tolerance test. According to the blood glucose level, they were divided into normal blood glucose group, fasting blood glucose abnormal group, postprandial hyperglycemia group and diabetic group. The extent of myocardial infarction and myocardial ischemia, the incidence of heart failure and in-hospital mortality were measured by electrocardiogram and echocardiography. Results There was no significant difference in the range of myocardial infarction and myocardial ischemia between the normal blood glucose group and the fasting blood glucose group, but the range of the myocardial infarction and myocardial ischemia in the group with postprandial hyperglycemia and diabetes was significantly greater than that in the former two groups (P <0.05) The difference was not significant (P> 0.05). The detection rate of heart failure in normal blood glucose group and fasting blood glucose group were basically the same. The detection rate of heart failure in postprandial hyperglycemia group was higher than that in the former two groups, but the difference was not significant (P> 0.05). The detection rate of heart failure in diabetic group Was 65.2%, significantly higher than the first three groups (P <0.01). During the hospitalization period, there were 5 deaths in the diabetes group, accounting for 7.1% and the remaining death rates were 0 in each group. There was no significant difference in the detection rates of all the above abnormalities (P> 0.05). Conclusions The detection rate of myocardial infarction, myocardial ischemia and heart failure in patients with acute coronary syndrome is closely related to their blood glucose level. The incidence of postprandial hyperglycemia and diabetes mellitus is significantly increased.