血糖波动对急性心肌梗死患者左心功能的影响研究

发布时间：2018-04-06 23:33

本文选题：心肌梗死　切入点：血糖　出处：《中国全科医学》2017年10期

【摘要】：目的探讨血糖波动对急性心肌梗死(AMI)患者左心功能的影响。方法选取2014年10月—2015年12月在首都医科大学附属北京安贞医院住院的首次AMI、择期冠状动脉造影患者207例,采用动态血糖监测系统(CGMS)测量日内平均血糖波动幅度(MAGE),根据MAGE水平分为低MAGE组(n=132)和高MAGE组(n=75)。收集患者的一般资资料[包括性别、年龄、既往史、糖尿病病程、BMI、收缩压(SBP)、舒张压(DBP)、心率(HR)、ST段抬高型心肌梗死发生情况、Killip分级]、实验室检查结果 [包括空腹血糖(FPG)、糖化血红蛋白(Hb A1c)]及超声心动图检查结果 [包括左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)]。结果两组男性比例、年龄、BMI、SBP、DBP、高血压发生率、ST段抬高型心肌梗死发生率间差异无统计学意义(P0.05);而HR、糖尿病发生率、糖尿病病程间差异有统计学意义(P0.05)。两组FPG、Hb A1c水平及Killip分级、LVEF、LVEDD间差异均有统计学意义(P0.05)。LVEF与FPG、Hb A1c、MAGE水平均呈直线负相关(r值分别为-0.34、-0.33、-0.41,P0.05);Killip分级与FPG、Hb A1c、MAGE水平均呈正相关(rs值分别为0.29、0.28、0.29,P0.05)。多因素线性回归分析结果显示,MAGE水平是LVEF的独立危险因素(P0.05)。多因素Logistic回归分析结果显示,MAGE水平是Killip分级的独立危险因素(P0.05)。结论血糖波动幅度较大与AMI患者左心功能的恶化明显相关。
[Abstract]:Objective to investigate the effect of blood glucose fluctuation on left ventricular function in patients with acute myocardial infarction (AMI).Methods 207 patients with selective coronary angiography were selected from October 2014 to December 2015 in Beijing Anzhen Hospital affiliated to Capital Medical University.The dynamic blood glucose monitoring system (CGMS) was used to measure the fluctuation amplitude of intraday blood glucose. According to the level of MAGE, it was divided into two groups: low MAGE group (n = 132) and high MAGE group (n = 75).Collect general data of patients [including gender, age, past history,BMI, SBP, DBP, HRT, ST-segment elevation myocardial infarction and Killip grade, laboratory results [including fasting blood glucose, FPGN, glycosylated hemoglobin, HbA1c] and echocardiographyThe left ventricular ejection fraction (LVEF) and left ventricular end diastolic diameter (LVEDDD) were included.Results there was no significant difference in the incidence of hypertension and ST-segment elevation myocardial infarction between the two groups (P 0.05), but there was no significant difference in the incidence of HRDM and the course of diabetes between the two groups (P 0.05).Multivariate linear regression analysis showed that age level was an independent risk factor for LVEF (P 0.05).Multivariate Logistic regression analysis showed that age level was an independent risk factor for Killip grading (P 0.05).Conclusion there is a significant correlation between the fluctuation of blood glucose and the deterioration of left ventricular function in patients with AMI.
【作者单位】：首都医科大学附属北京安贞医院特需医疗科;
【基金】：北京市保健专项基金科研课题(京15-10号)
【分类号】：R542.22

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