新疆汉族、维吾尔族、哈萨克族既往未诊断糖尿病的住院急性冠状动脉综合征患者糖代谢异常分析

目的分析新疆汉族、维吾尔（维）族、哈萨克（哈）族既往未诊断糖尿病的急性冠状动脉综合征（ACS）住院患者的糖代谢异常情况。方法收集2010年9月至2012年9月住院的、既往未诊断糖尿病的ACS患者共581例，对于空腹血糖不能明确诊断糖尿病的患者，进行口服葡萄糖耐量试验（OG＇IT），以分析其糖代谢情况。结果（1）581例既往未诊断糖尿病的住院ACS患者中，汉族337例，维族219例，哈族25例。检测后共发现糖代谢异常428例（73．7％），其中糖尿病患者245例（42．2％），汉族146例（43．3％），维族96例（43．8％），哈族3例（12．0％）；（2）糖调节异常共183例（31．5％），其中汉族114例（33．8％），维族65例（29．7％），哈族4例（16．0％）；（3）若不进行OGTT试验，仅靠检测空腹血糖，既往未诊断糖尿病的ACS患者，将有38．0％的糖尿病患者被漏诊，43．7％的糖调节受损患者被漏诊，3个月后复查差异无统计学意义（P〈0．05）。结论新疆汉族、维族、哈族三民族既往未诊断糖尿病的ACS患者总体糖代谢异常率为73．7％，哈族偏低。仅检测空腹血糖将有很多ACS患者漏诊糖代谢异常。

Analysis of abnormal glucose metabolism in acute coronary syndrome patients without diagnosed diabetes mellitus in Han, Uygur and Kazak people in Xinjiang China

Objective To investigate the abnormal glucose metabolism in acute coronary syndrome （ACS） inpatients without diagnosed history of diabetes mellitus （DM） of HaM, Uygur and Kazak people in Xinjiang. Methods Five hundred and eighty-one ACS cases without DM were collected from September 2010 to September 2012 in three ethnic inpatients. Oral glucose tolerance （OG3T） were underwent to determine the glucose metabolism if they could not be clearly diagnosed as diabetes by fasting plasma glucose. Results Total of 428 cases （73.7%） had abnormal glucose metabolism, including 245 patients （42. 2% ） with DM and 183 cases （31.5%） with abnormal glucose regulation. There were 337 HaM cases with ACS, including 146 cases （43.3%） with diabetes mellitus and 114 cases （33.8%） with glucose regulation abnormality. There were 219 Uygur cases, including 96 cases （43.8%） with DM and 65 cases （29. 7% ） with abnormal glucose regulation. There were 25 Kazak cases, including 3 cases （ 12.0% ） with DM and 4 cases （ 16. 0% ） with abnormal glucose regulation. Without OGTT test, only recognized by fasting blood glucose, 38.0% diabetes mellitus patients would be missed and 43.7% impaired glucose regulation patients would be missed in patients without diagnosed history of DM. There was no statistically significant difference in follow-up after 3 months （ P 〈 0. 05 ）. Conclusion There are 428 cases （ 73.7% ） with abnormal glucose metabolism in HaM, Uygur and Kazak ACS patients without diagnosis history of DM in Xinjiang, and the incidence is the lowest in kazak patients. Only relying on fasting blood glucose, a considerable number of ACS patients with abnormal glucose metabolism would be missed.