急性冠状动脉综合征住院患者的急性期高血糖：患病率及预后意义
Acute Phase Hyperglycemia among Patients Hospitalized with Acute Coronary Syndrome: Prevalence and Prognostic Significance.
作者信息
Mansour Abbas Ali, Wanoose Hameed Laftah
出版信息
Oman Med J. 2011 Mar;26(2):85-90. doi: 10.5001/omj.2011.22.
OBJECTIVES
Regardless of diabetes status, hyperglycemia on arrival for patients presenting with acute coronary syndrome, has been associated with adverse outcomes including death. The aim of this study is to look at the frequency and prognostic significance of acute phase hyperglycemia among patients attending the coronary care unit with acute coronary syndrome over the in-hospital admission days.
METHODS
The study included 287 consecutive patients in the Al-Faiha Hospital in Basrah (Southern Iraq) during a one year period from December 2007 to November 2008. Patients were divided into two groups with respect to admission plasma glucose level regardless of their diabetes status (those with admission plasma glucose of <140 mg/dl (7.8 mmol/L) and those equal to or more than that). Acute phase hyperglycemia was defined as a non-fasting glucose level equal to or above 140 mg/dl (7.8 mmol/L) regardless of past history of diabetes.
RESULTS
Sixty one point seven percent (177) of patients were admitted with plasma glucose of ³140 mg/dl (7.8 mmol/L). There were no differences were found between both groups regarding the mean age, qualification, and smoking status, but males were predominant in both groups. A family history of diabetes, and hypertension, were more frequent in patients with plasma glucose of ³140 mg/dl (7.8 mmol/L). There were no differences between the two groups regarding past history of ischemic heart disease, stroke, lipid profile, troponin-I levels or type of acute coronary syndrome. Again heart failure was more common in the admission acute phase hyperglycemia group, but there was no difference regarding arrhythmia, stroke, or death. Using logistic regression with heart failure as the dependent variable we found that only the admission acute phase hyperglycemia (OR=2.1344, 95% CI=1.0282-4.4307; p=0.0419) was independently associated with heart failure. While male gender, family history of diabetes mellitus, hypertension and diabetes were not independently associated with heart failure.
CONCLUSION
Admission acute phase hyperglycemia of ³140 mg/dl (7.8 mmol/L) was associated with heart failure in this study.
目的
无论糖尿病状态如何，急性冠状动脉综合征患者入院时的高血糖与包括死亡在内的不良结局相关。本研究的目的是观察冠心病监护病房中急性冠状动脉综合征患者在住院期间急性期高血糖的发生率及其预后意义。
方法
该研究纳入了2007年12月至2008年11月期间伊拉克巴士拉法伊哈医院连续收治的287例患者。根据入院时血浆葡萄糖水平，无论其糖尿病状态如何，将患者分为两组（入院血浆葡萄糖<140mg/dl（7.8mmol/L）的患者和血浆葡萄糖等于或高于此水平的患者）。急性期高血糖定义为无论既往糖尿病史如何，非空腹血糖水平等于或高于140mg/dl（7.8mmol/L）。
结果
61.7%（177例）患者入院时血浆葡萄糖≥140mg/dl（7.8mmol/L）。两组在平均年龄、学历和吸烟状况方面无差异，但两组中男性均占主导。血浆葡萄糖≥140mg/dl（7.8mmol/L）的患者中，糖尿病家族史和高血压更为常见。两组在缺血性心脏病、中风、血脂谱、肌钙蛋白I水平或急性冠状动脉综合征类型的既往史方面无差异。同样，心力衰竭在入院急性期高血糖组中更常见，但在心律失常、中风或死亡方面无差异。以心力衰竭作为因变量进行逻辑回归分析，我们发现只有入院急性期高血糖（OR=2.1344，95%CI=1.0282-4.4307；p=0.0419）与心力衰竭独立相关。而男性性别、糖尿病家族史、高血压和糖尿病与心力衰竭无独立相关性。
结论
在本研究中，入院急性期血浆葡萄糖≥140mg/dl（7.8mmol/L）与心力衰竭相关。
Zotero 插件