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Inadequate blood glucose control is associated with in-hospital mortality and morbidity in diabetic and nondiabetic patients undergoing cardiac surgery.血糖控制不佳与接受心脏手术的糖尿病和非糖尿病患者的院内死亡率及发病率相关。
Circulation. 2008 Jul 8;118(2):113-23. doi: 10.1161/CIRCULATIONAHA.107.706416.
2
Glucose metabolism and catecholamines.葡萄糖代谢与儿茶酚胺
Crit Care Med. 2007 Sep;35(9 Suppl):S508-18. doi: 10.1097/01.CCM.0000278047.06965.20.
3
Prevalence of cardiovascular risk factors in Indian patients undergoing coronary artery bypass surgery.接受冠状动脉搭桥手术的印度患者心血管危险因素的患病率
J Assoc Physicians India. 2006 May;54:371-5.
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Hyperglycemia during cardiopulmonary bypass is an independent risk factor for mortality in patients undergoing cardiac surgery.体外循环期间的高血糖是心脏手术患者死亡的独立危险因素。
J Thorac Cardiovasc Surg. 2005 Oct;130(4):1144. doi: 10.1016/j.jtcvs.2005.05.049.
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Prevalence of the metabolic syndrome in patients with coronary heart disease, cerebrovascular disease, peripheral arterial disease or abdominal aortic aneurysm.冠心病、脑血管疾病、外周动脉疾病或腹主动脉瘤患者中代谢综合征的患病率。
Atherosclerosis. 2004 Apr;173(2):363-9. doi: 10.1016/j.atherosclerosis.2003.12.033.
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Tight glycemic control in diabetic coronary artery bypass graft patients improves perioperative outcomes and decreases recurrent ischemic events.糖尿病冠状动脉搭桥术患者的严格血糖控制可改善围手术期结局并减少复发性缺血事件。
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Continuous insulin infusion reduces mortality in patients with diabetes undergoing coronary artery bypass grafting.持续胰岛素输注可降低接受冠状动脉旁路移植术的糖尿病患者的死亡率。
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Outcomes and perioperative hyperglycemia in patients with or without diabetes mellitus undergoing coronary artery bypass grafting.接受冠状动脉搭桥术的糖尿病患者与非糖尿病患者的手术结果及围手术期高血糖情况。
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冠状动脉旁路移植术(CABG)后新发糖尿病的发生率:单中心登记数据的分析

Incidence of new diabetes following CABG surgery: Analysis of a single centre registry data.

作者信息

Lodha Sailesh, Sharma Krishna Kumar, Bana Ajeet, Mehta Navneet, Gupta Rajeev

机构信息

Department of Endocrinology, Eternal Heart Care Centre & Research Institute, India.

Department of Clinical Research, Eternal Heart Care Centre & Research Institute, India.

出版信息

Indian Heart J. 2018 Dec;70 Suppl 3(Suppl 3):S221-S223. doi: 10.1016/j.ihj.2018.11.017. Epub 2018 Dec 7.

DOI:10.1016/j.ihj.2018.11.017
PMID:30595262
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6310740/
Abstract

BACKGROUND

About 40-50% of patients undergoing coronary artery bypass graft (CABG) surgery have diabetes. The prevalence of impaired glucose tolerance (IGT) is also high in this group, however, incidence of new diabetes following CABG surgery is unknown.

OBJECTIVES

To determine incidence of new diabetes and the impact on ICU and hospital stay in patients undergoing CABG surgery in India, we performed a registry-based study.

METHODS

Prospectively collected data among consecutive adult cardiac surgical patients who underwent CABG surgery at a single hospital were analyzed. Descriptive statistics are reported.

RESULTS

We recruited 1559 consecutive patients (men 1355, women 204) and analyzed data among 933 non-diabetic patients. Patients with known diabetes (n = 626, 40%) were excluded. 57 (6.1%) of the 933 non-diabetic patients developed persistently high glucose levels at discharge with incidence rate of 61 + 5/1000. Patients who developed diabetes had similar age and body mass index vs those who did not, but had greater preoperative IGT (44.6 vs 13.7%) and more time-period in intensive care unit (102.0 + 75 vs 80.2 + 29 hours) as well as in hospital (11.7 + 5.7 vs 9.6 + 2.4 days) (p < 0.001).

CONCLUSION

In a significant proportion of non-diabetic patients diabetes is unmasked after CABG. This is more likely in those with impaired glucose tolerance and prolonged period in intensive care and hospital.

摘要

背景

接受冠状动脉搭桥术(CABG)的患者中约40%-50%患有糖尿病。该群体中糖耐量受损(IGT)的患病率也很高,然而,CABG术后新发糖尿病的发生率尚不清楚。

目的

为了确定印度接受CABG手术患者中新发糖尿病的发生率及其对重症监护病房(ICU)住院时间和医院住院时间的影响,我们进行了一项基于登记的研究。

方法

对在一家医院连续接受CABG手术的成年心脏外科患者前瞻性收集的数据进行分析。报告描述性统计结果。

结果

我们招募了1559例连续患者(男性1355例,女性204例),并分析了933例非糖尿病患者的数据。排除已知糖尿病患者(n = 626,40%)。933例非糖尿病患者中有57例(6.1%)出院时血糖持续升高,发生率为61 + 5/1000。发生糖尿病的患者与未发生糖尿病的患者年龄和体重指数相似,但术前IGT更高(44.6%对13.7%),在重症监护病房的时间更长(102.0 + 75小时对80.2 + 29小时)以及住院时间更长(11.7 + 5.7天对9.6 + 2.4天)(p < 0.001)。

结论

在相当一部分非糖尿病患者中,CABG术后糖尿病被暴露出来。糖耐量受损以及在重症监护病房和医院停留时间延长的患者更易发生。