冠心病监护病房血糖控制概述及临床管理建议
An overview of glycemic control in the coronary care unit with recommendations for clinical management.
作者信息
Kosiborod Mikhail, Deedwania Prakash
机构信息
Mid America Heart Institute of Saint Luke's Hospital, Kansas City, Missouri 64111, USA.
出版信息
J Diabetes Sci Technol. 2009 Nov 1;3(6):1342-51. doi: 10.1177/193229680900300614.
Abstract
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.
摘要
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。
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本文引用的文献
1
American Association of Clinical Endocrinologists and American Diabetes Association consensus statement on inpatient glycemic control.美国临床内分泌医师协会与美国糖尿病协会关于住院患者血糖控制的共识声明。
Diabetes Care. 2009 Jun;32(6):1119-31. doi: 10.2337/dc09-9029. Epub 2009 May 8.
2
Tight glycemic control reduces heart inflammation and remodeling during acute myocardial infarction in hyperglycemic patients.严格血糖控制可减轻高血糖患者急性心肌梗死期间的心脏炎症和重塑。
J Am Coll Cardiol. 2009 Apr 21;53(16):1425-36. doi: 10.1016/j.jacc.2009.01.041.
3
Relationship between spontaneous and iatrogenic hypoglycemia and mortality in patients hospitalized with acute myocardial infarction.急性心肌梗死住院患者自发性和医源性低血糖与死亡率的关系。
JAMA. 2009 Apr 15;301(15):1556-64. doi: 10.1001/jama.2009.496.
4
Elevated admission glucose and mortality in elderly patients hospitalized with heart failure.因心力衰竭住院的老年患者入院时血糖升高与死亡率
Circulation. 2009 Apr 14;119(14):1899-907. doi: 10.1161/CIRCULATIONAHA.108.821843. Epub 2009 Mar 30.
5
Intensive versus conventional glucose control in critically ill patients.危重症患者强化血糖控制与常规血糖控制的比较
N Engl J Med. 2009 Mar 26;360(13):1283-97. doi: 10.1056/NEJMoa0810625. Epub 2009 Mar 24.
6
Glucose normalization and outcomes in patients with acute myocardial infarction.急性心肌梗死患者的血糖正常化与预后
Arch Intern Med. 2009 Mar 9;169(5):438-46. doi: 10.1001/archinternmed.2008.593.
7
Association of elevated fasting glucose with increased short-term and 6-month mortality in ST-segment elevation and non-ST-segment elevation acute coronary syndromes: the Global Registry of Acute Coronary Events.空腹血糖升高与ST段抬高型和非ST段抬高型急性冠脉综合征短期及6个月死亡率增加的关联：全球急性冠脉事件注册研究
Arch Intern Med. 2009 Feb 23;169(4):402-9. doi: 10.1001/archinternmed.2008.572.
8
Prognostic implications of hypoglycaemic episodes during hospitalisation for myocardial infarction in patients with type 2 diabetes: a report from the DIGAMI 2 trial.2型糖尿病患者心肌梗死住院期间低血糖发作的预后意义：DIGAMI 2试验报告
Heart. 2009 May;95(9):721-7. doi: 10.1136/hrt.2008.152835. Epub 2008 Nov 24.
9
Hyperglycemia and acute coronary syndrome: a scientific statement from the American Heart Association Diabetes Committee of the Council on Nutrition, Physical Activity, and Metabolism.高血糖与急性冠状动脉综合征：美国心脏协会营养、体育活动与新陈代谢委员会糖尿病委员会的科学声明
Circulation. 2008 Mar 25;117(12):1610-9. doi: 10.1161/CIRCULATIONAHA.107.188629. Epub 2008 Feb 25.
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Circulation. 2008 Feb 26;117(8):1018-27. doi: 10.1161/CIRCULATIONAHA.107.740498. Epub 2008 Feb 11.
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