Kosiborod Mikhail, Deedwania Prakash
Mid America Heart Institute of Saint Luke's Hospital, Kansas City, Missouri 64111, USA.
J Diabetes Sci Technol. 2009 Nov 1;3(6):1342-51. doi: 10.1177/193229680900300614.
The observation that elevated glucose occurs frequently in the setting of acute myocardial infarction was made decades ago. Since then numerous studies have documented that hyperglycemia is a powerful risk factor for increased mortality and in-hospital complications in patients with acute coronary syndromes. While some questions in this field have been answered in prior investigations, many critical gaps in knowledge continue to exist and remain subjects of intense debate. This review summarizes what is known about the relationship between hyperglycemia, glucose control, and outcomes in critically ill patients with acute coronary syndromes, addresses the gaps in knowledge and controversies, and offers general recommendations regarding glucose management in the coronary care unit.
数十年前就已观察到，急性心肌梗死患者中经常出现血糖升高的情况。从那时起，大量研究表明，高血糖是急性冠脉综合征患者死亡率增加和院内并发症的一个强大危险因素。虽然该领域的一些问题在之前的研究中已经得到解答，但许多关键的知识空白仍然存在，并且仍是激烈辩论的主题。本综述总结了关于急性冠脉综合征重症患者高血糖、血糖控制与预后之间关系的已知情况，阐述了知识空白和争议点，并就冠心病监护病房的血糖管理提出了一般性建议。
