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急性冠状动脉缺血发生过程中非糖尿病患者的低血糖症

Hypoglycemia in Non-diabetics During Development of Acute Coronary Ischemia.

作者信息

Novakovic Ana, Zukic Ejub, Gazibera Belma, Gojak Refet

机构信息

Primary Health Care Center Gornji Vakuf-Uskoplje, Bosnia and Herzegovina.

Clinic of Infectious disease, University Clinical Center Sarajevo, Bosnia and Herzegovina.

出版信息

Med Arch. 2015 Aug;69(4):226-8. doi: 10.5455/medarh.2015.69.226-228. Epub 2015 Aug 4.

Abstract

INTRODUCTION

The occurrence of hyperglycemia in non-diabetics during development of acute coronary ischemia (ACI) indicates latent glucose metabolism disorder, or is a case of newly discovered diabetes mellitus (DM) as a result of stress. Acute coronary syndrome refers to a group of clinical syndromes caused by a sudden circulatory disorder in coronary arteries, resulting in the corresponding myocardial ischemia. It covers range from unstable angina and myocardial infarction (MI) without Q wave in the electrocardiogram finding (NSTEMI) up to myocardial infarction with Q wave in the electrocardiogram finding (STEMI).

GOAL

To determine the incidence of hyperglycemia in non-diabetics immediately after the occurrence of acute coronary ischemia and assess its risk factors.

RESULTS

The sample included 80 respondents. Men dominated with a total prevalence of 77.5%. The respondent was at mean age of 62.8±13.8 years. During the first measurement, immediately after hospital admission, 50% of respondents had increased blood glucose value and during the second measurement 62%. Hypertension as a risk factor has 54% and 56% smoking. The incidence of stress diabetes after ACI does not depend on the diagnosis of hypertension, χ(2)=0.050; p=0.823. The differences of mean values (median) BMI between examined persons with/without stress DM are not statistically significant p=0.402. Independent t-test showed that there was no statistically significant difference in the average values of HDL and LDL in patients with stress diabetes than in patients without diabetes stress after ACI p>0.05. For each year of age odds ratio for "stress diabetes" increases by 7% and 95% CI is 2% -12%.

CONCLUSION

The incidence of stress diabetes ACI is not dependent on the working diagnosis (MI or angina pectoris). As risk factors we set hypertension and current smoking. There were no statistically significant associations between active smoking and hypertension as a risk factor in relation to occurrence of stress diabetes.

摘要

引言

非糖尿病患者在急性冠状动脉缺血(ACI)发生期间出现高血糖表明存在潜在的糖代谢紊乱,或者是应激导致新发现的糖尿病(DM)。急性冠状动脉综合征是指由冠状动脉突然循环障碍引起的一组临床综合征,导致相应的心肌缺血。它涵盖了从不稳定型心绞痛和心电图检查无Q波的心肌梗死(NSTEMI)到心电图检查有Q波的心肌梗死(STEMI)的范围。

目的

确定急性冠状动脉缺血发生后非糖尿病患者高血糖的发生率,并评估其危险因素。

结果

样本包括80名受访者。男性占主导,总患病率为77.5%。受访者的平均年龄为62.8±13.8岁。在首次测量时,即入院后立即进行测量,50%的受访者血糖值升高,第二次测量时为62%。作为危险因素的高血压患病率为54%,吸烟患病率为56%。ACI后应激性糖尿病的发生率不取决于高血压的诊断,χ(2)=0.050;p=0.823。有/无应激性糖尿病的受检者之间平均(中位数)BMI值的差异无统计学意义,p=0.402。独立t检验显示,ACI后有应激性糖尿病的患者与无糖尿病应激的患者相比,HDL和LDL的平均值无统计学显著差异,p>0.05。“应激性糖尿病”的年龄比值比每年增加7%,95%可信区间为2% - 12%。

结论

ACI后应激性糖尿病的发生率不取决于现行诊断(心肌梗死或心绞痛)。我们确定高血压和当前吸烟为危险因素。就应激性糖尿病的发生而言,主动吸烟与高血压作为危险因素之间无统计学显著关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5c0/4610607/67a5fa650c69/MA-69-226-g002.jpg

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