稳定型冠心病及合并糖尿病危险因素的高血压患者糖代谢异常筛查

目的调查在心内科门诊中既往无糖代谢异常病史的稳定型冠心病及合并糖尿病危险因素的高血压患者的糖代谢异常发生情况。方法对入选患者进行空腹或餐后毛细血管血糖检测,空腹血糖≥6.1 mmol/L或餐后随机血糖≥7.8 mmol/L的患者再进行口服葡萄糖耐量试验(OGTT)。结果共1412例患者进行毛细血管血糖检测,其中939例患者进行空腹血糖检测,281例(29.9%)患者空腹血糖≥6.1 mmol/L并且<7.0 mmol/L,105例(11.2%)患者空腹血糖≥7.0 mmol/L;473例患者进行餐后随机血糖检测,123例(26.0%)患者随机血糖≥7.8 mmol/L并且<11.1 mmol/L,43例(9.1%)患者随机血糖≥11.1 mmol/L。入选患者共552例(39.1%)毛细血管空腹血糖≥6.1 mmol/L或随机血糖≥7.8 mmol/L,其中298例患者又进行了OGTT,正常糖耐量(NGT)66例(22.1%),糖调节受损(IGR)132例(44.3%),其余100例(33.6%)患者新诊断为糖尿病。结论对既往无糖代谢异常病史的稳定型冠心病及合并糖尿病危险因素的高血压患者进行毛细血管血糖筛查及OGTT有助于早期发现糖代谢异常。

Prevalence of abnormal glucose metabolism in patients with stable coronary artery disease or hypertension with diabetes risk factors

Objective To investigate the prevalence of abnormal glucose metabolism in patients with stable coronary artery disease but without glucose metabolic abnormalities history,or with both hypertension and diabetes risk factors. Methods Fasting or postprandial random blood sugar screening was performed in cardiovascular outpatients with stable coronary artery disease but without glucose metabolic abnormalities history,or with both hypertension and diabetes risk factors.According to the results of screening,patients with abnormal glucose metabolism accepted oral glucose tolerance test(OGTT). Results Totally 1412 patients were enrolled for blood sugar screening,of which 939 accepted fasting capillary blood sugar measuring.Fasting capillary glucose was ≥6.1 mmol/L but <7.0 mmol/L in 281(29.9%) patients and ≥7.0 mmol/L in 105(11.2%) patients.473 patients accepted postprandial random capillary blood sugar screening.Postprandial random capillary blood sugar was ≥7.8 mmol/L but <11.1 mmol/L in 123(26.0%) patients and ≥11.1 mmol/L in 43(9.1%) patients.39.1%(552 cases) of all patients had abnormal glucose metabolism and 298 patients accepted OGTT.According to the results of OGTT,132(44.3%) patients were diagnosed as impaired glucose regulation and 100 patients(33.6%) newly diagnosed diabetes. Conclusions The incidence of abnormal glucose metabolism is high in cardiovascular outpatients with stable coronary artery disease but without glucose metabolic abnormalities history,as well as in those with both hypertension and diabetes risk factors.Capillary blood sugar screening combined with OGTT can help to early diagnose abnormal glucose metabolism.