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测定糖化血红蛋白HbA和果糖胺在评估2型糖尿病患者心脏手术后围手术期并发症风险中的价值。

Determination of the value of glycated hemoglobin HbA and fructosamine in assessing the risk of perioperative complications after cardiac surgery in patients with type 2 diabetes.

作者信息

Kowalczuk-Wieteska Anetta M, Wróbel Marta, Rokicka Dominika, Szymborska-Kajanek Aleksandra, Foremny Jerzy, Nadziakiewicz Paweł, Zembala Marian, Strojek Krzysztof

机构信息

Department of Cardiac, Vascular and Endovascular Surgery and Transplantology, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Diseases, Zabrze, Poland.

Department of Internal Diseases, Diabetology and Cardiometabolic Diseases, SMDZ in Zabrze, Medical University of Silesia in Katowice, Silesian Center for Heart Diseases, Zabrze, Poland.

出版信息

Kardiochir Torakochirurgia Pol. 2016 Dec;13(4):305-308. doi: 10.5114/kitp.2016.64869. Epub 2016 Dec 30.

Abstract

INTRODUCTION

Patients with diabetes have a worse postoperative course and longer length of hospital stay after surgery. A good indicator of proper long-term (3 months) glycemic control is glycated hemoglobin (HbA), and fructosamine in the short term (2-3 weeks).

AIM

To determine the degree of glycemic control evaluated preoperatively by HbA and/or fructosamine influence on the postoperative course of patients with diabetes undergoing coronary artery bypass grafting (CABG) in 2014-2015.

MATERIAL AND METHODS

Before the operation HbA (N < 7.0) and fructosamine (N < 280 µmol/l) were measured and depending on the results the respondents were divided into 4 groups: group I ( = 46) - normal both parameters; group II ( = 22) - high both values; group III ( = 4) - normal fructosamine/HbA high; group IV ( = 33) - high HbA/fructosamine normal. Statistical analysis was performed using the -test assuming < 0.05 to be statistically significant.

RESULTS

One hundred and five patients were treated by CABG/OPCAB (39 female, 66 males). The mean age was 65.7 ±7.3, HbA: 7.23 ±1.2%, fructosamine: 261.8 ±43.8. There was no difference in the incidence of other postoperative complications between the two groups.

CONCLUSIONS

Glycated hemoglobin and fructosamine levels to a similar extent define the risk of perioperative complications in patients undergoing cardiac surgery. In patients in whom there is a need to quickly compensate for elevated blood glucose consider enabling determination of fructosamine.

摘要

引言

糖尿病患者术后恢复过程较差,住院时间更长。糖化血红蛋白(HbA)是长期(3个月)血糖控制良好的一个良好指标,而果糖胺则是短期(2 - 3周)血糖控制的指标。

目的

确定2014 - 2015年接受冠状动脉旁路移植术(CABG)的糖尿病患者术前通过HbA和/或果糖胺评估的血糖控制程度对术后恢复过程的影响。

材料与方法

术前测量HbA(N < 7.0)和果糖胺(N < 280 μmol/l),并根据结果将受试者分为4组:第一组(n = 46)——两项参数均正常;第二组(n = 22)——两项值均高;第三组(n = 4)——果糖胺正常/HbA高;第四组(n = 33)——HbA高/果糖胺正常。采用t检验进行统计分析,假设P < 0.05具有统计学意义。

结果

105例患者接受了CABG/非体外循环冠状动脉搭桥术(OPCAB)治疗(39例女性,66例男性)。平均年龄为65.7 ± 7.3岁,HbA:7.23 ± 1.2%,果糖胺:261.8 ± 43.8。两组之间其他术后并发症的发生率没有差异。

结论

糖化血红蛋白和果糖胺水平在相似程度上确定了心脏手术患者围手术期并发症的风险。对于需要快速纠正血糖升高的患者,考虑进行果糖胺测定。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b06/5233758/aad24981a9c7/KITP-13-28998-g001.jpg

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