胰岛素强化治疗急性心肌梗死伴高血糖50例效果观察

耳的探讨胰岛素强化治疗对急性心肌梗死伴高血糖患者的血清CRP与预后的影响。方法100例急性心肌梗死伴高血糖患者随机分成二组，治疗组50例给予胰岛素强化治疗，使血糖控制在4．4～6．1mmol／L，观察组50例给予常规胰岛素治疗，使血糖控制在8．3～11．1mmol／L，观察二组患者血清CRP的变化，比较分析二组患者病死率、心律失常、心力衰竭、院内感染、低血糖发生率。结果强化治疗组患者赠律失常、心力衰竭、院内感染发生率、48hCRP水平明显低于常规治疗组（P〈0．05），但低血糖发生率强化治疗组明显低于常规治疗组（P〈0．05）。结论胰岛素强化治疗有利于降低急性心肌梗死伴高血糖患者血清CRP水平，有助于改善患者预后。

EFFECTS OF INTENSIVE INSULIN THERAPY ON PATIENTS WITH ACUTE MYOCARDIAL INFARCTION COM-BINED HYPERGLYCEMIA

Objective To investigate the influence of intensive insulin therapy on the level of C- reactive protein （CRP） and the indexes of prognosis in acute myocardial infarction patients with hyperglycemia. Methods 100 acute myocardial infarction patients with hyperglycemia were randomly divided into two groups. One group （n = 50） received intensive insulin therapy, the blood glucose levels were controlled between 4.4 to 6.1 mmol/L, while the other group （n = 50） received routine insulin therapy and the blood glucose levels were controlled between 8.3 to 11. lmmol/L. The changes of CRP and some parameters as follows were observed in two groups： the mortality, incidence rate of heart failure, incidence rate of cardiac dysrhythmia, incidence rate of nosocomial infection and morbidity of hypoglycemia. Results Except the morbidity of hypoglycemia was significantly higher in the intensive therapy group than that in the control group （P〈0.05） ,other parameters such as incidence rate of heart failure, incidence rate of cardiac dysrhythmia, incidence rate of nosocomial infection were lower in the intensive therapy group than those in the control group（P〈0. 05）. Conclusion Intensive insulin therapy improves the critical condition and decreases the CRP level in acute myocardial infarction patients with hyperglycemia.