糖尿病和糖耐量异常患者在急性缺血性脑血管病中的调查研究

目的 探讨糖尿病和糖耐量异常患者在急性缺血性脑血管病中的流行情况.方法 选择急诊内科病房及神经内科住院的115例短暂性脑缺血发作(TIA)、496例急性脑梗死患者进行空腹血糖、糖化血红蛋白检测,登记患者的临床资料,对既往未诊断糖尿病而空腹血糖在6.1～6.9 mmol/L的患者中进行口服葡萄糖耐量试验(OGTT),糖代谢分类采用2003年美国糖尿病学会建议标准.结果 611例急性缺血性脑血管病患者住院前糖尿病的诊断率18.8%,住院后系统检查发现糖尿病新的患病率45.0%,糖耐量异常18.6%;212例空腹血糖在6.1～6.9 mmol/L的患者中,OGTT发现其中33.5%患者可诊断为糖尿病,53.8%提示糖耐量异常.结论 63.8%的急性缺血性脑血管病患者合并糖尿病或糖耐量异常;空腹血糖在6.1～6.9 mmol/L的患者应常规做OGTT检查来筛查糖代谢异常患者.     

Screening for undiagnosed diabetes in patients with acute myocardial infarction

Background  Screening for undiagnosed diabetes in patients with acute myocardial infarction is recommended (ESC and EASD Task Force 2007). Glucose tolerance testing in the peri-infarct period may not be valid because of confounding, e.g. by the acute stress reaction. The aim was to evaluate undiagnosed diabetes (DM) and impaired glucose regulation (IGR) in AMI during hospital stay and 3 months after discharge. Materials and methods  In 96 consecutively admitted AMI patients (Heart Center Wuppertal, Germany) OGTT were performed, of whom in 62 OGTT were also carried out 3 months later. Results  Before discharge 32% of the patients had newly diagnosed diabetes and 47% patients had prediabetes (IGR). Glucose tolerance was normal in 20 (21%) patients only. After 3 months, 74% with newly diagnosed DM at baseline still had disturbed glucose metabolism (58% DM, 16% IGT). No patient with normal OGTT became diabetic after 3 months. In multivariate regression, the odds of having diabetes (3 months) was about sixfold higher when having diabetes before discharge (OGTT). Admission glucose, infarction size CK_MAX, and inflammation (CRP) were not significantly related to OGTT results. Conclusions  This prospective study confirms a high prevalence of undiagnosed DM in patients with AMI. In about 60% of AMI patients, newly diagnosed DM persisted after 3 months. For the first time we could show that there is no correlation between infarction size and undiagnosed diabetes. Thus, an OGTT performed before discharge may provide a reliable measure of disturbed glucose regulation but needs to be repeated. M. Lankisch and R. Füth equally contributed to this work.     

空腹血糖正常的原发性高血压患者糖代谢异常状况研究

目的研究原发性高血压伴有糖代谢异常患者的各项指标,为全面干预心血管危险因素提供依据。方法选择既往无糖代谢异常病史,空腹血糖〈5.6 mmol/L的原发性高血压患者398例,测定口服葡萄糖耐量试验（OGTT）后2小时血糖（2 hPG）水平。观察年龄、性别、体质量指数、血压、血脂、尿酸、动脉硬化等参数与OGTT后2hPG的关系。结果 398例患者中检出糖耐量减低99例（24.9%）;2型糖尿病52例（13.1%）。糖代谢异常的患者动脉硬化的比例（71.5%）高于血糖正常组（52.6%）。结论原发性高血压患者合并糖代谢异常的比例高,对于空腹血糖正常的原发性高血压患者,应常规行OGTT测定,以早期发现和干预糖代谢紊乱,减少动脉硬化的发生。     

The Euro Heart Survey – Germany: diabetes mellitus remains unrecognized in patients with coronary artery disease

AIM: Diabetes mellitus is associated with a poor prognosis due to a high rate of coronary artery disease. It was the aim of this survey to assess the prevalence of an impaired glucose tolerance and manifest diabetes mellitus in patients with coronary artery disease (CAD). METHODS: We analyzed data of all German centers participating in the Euro Heart Survey on diabetes and the heart, an European-wide multicenter prospective observational study. Participating centers were asked to recruit patients >18 years with a diagnosis of CAD. RESULTS: In Germany, 261 patients with a diagnosis of CAD were enrolled in five participating centers. Patients were divided into an acutely (22,4%; n = 57) or electively admitted (77,6%; n = 198) group. There were 34% (n = 89) of patients with already known diabetes. In 36% (n = 22 of 56) of the patients without previously known diabetes, an oral glucose tolerance test (OGTT) was performed (3%, n = 5 in the acute and 33%, n = 51 in the elective group). As a result, 39% (n = 22 of 56) of these patients had an impaired glucose tolerance (acute group: 0%, n = 0 of 5; elective group: 43%, n = 22 of 51) and in 13% (n = 7 of 56) diabetes mellitus was diagnosed (acute group: 40%, n = 2 of 5; elective group: 10%, n = 5 of 51). Furthermore, on admission 86% of women and 94% of men reported to exercise less than three times per week and thus less than recommended in current guidelines. CONCLUSION: More than one third of the patients with CAD who underwent an OGTT had an impaired glucose tolerance. Implementation of this simple, effective and inexpensive test into clinical routine of patients with CAD would help diagnose diabetes mellitus and thus grant these high risk patients access to an optimal medical, interventional and surgical therapy. Furthermore, patients ought to be encouraged to include exercise training into their daily routine.     

Determinants for the progression from impaired glucose tolerance to non-insulin-dependent diabetes mellitus

The World Health Organization distinguishes among non-diabetic persons a form of glucose intolerance defined as impaired glucose tolerance (IGT). The main reason for considering IGT as a diagnostic entity is its prognostic value for the development of non-insulin-dependent diabetes mellitus (NIDDM). However, the use of one or two oral glucose tolerance tests (OGTT) for the definition of IGT and the large variability of the 2-h glucose level may explain the wide range of the incidence rates reported for NIDDM in subjects with IGT. It is evident that the pathogenesis of diabetes is still poorly understood. Both insulin resistance and impaired function of the β-cell are thought to be important contributing factors in the development of diabetes. The 2-h post-load glucose level from the OGTT is most powerful for the prediction of the development of NIDDM. In addition, a fasting hyperinsulinaemia and a low glucose removal rate, both reflecting insulin resistance, were found to be associated with a higher risk for the progression of NIDDM. In the San Antonio Study and in the Hoorn Study high fasting proinsulin levels, reflecting β-cell dysfunction, were associated with progression to NIDDM. Lipid levels did not predict progression to NIDDM in most studies. A two-step model for the development of NIDDM is hypothesized. The first step, the transition from normal to impaired glucose tolerance, is assumed to depend mainly on the presence of insulin resistance. The second step, progressing from IGT to diabetes, although accompanied by some further worsening of insulin resistance, is thought to be primarily dependent on the development of β-cell dysfunction.     

未诊断糖尿病的冠心病患者糖代谢状况分析

目的探讨未诊断糖尿病但经冠脉造影确诊的冠心病住院患者（CAD）的糖代谢状况。方法采用横断面研究设计,纳入2007年1月至2009年5月在中山大学附二院心血管内科住院的患者499例,根据冠脉造影结果分为冠心病组和非冠心病组,比较两组的糖代谢异常情况。结果两组随机血糖（RPG）和空腹血糖（FPG）差异无统计学意义（P值分别为0.249和0.444）,但OGTT 2小时血糖（2hPG）在冠心病组明显升高,差异有统计学意义（P〈0.001）;冠心病组糖代谢异常患病率达74.0%,其中新诊断糖尿病32.1%,糖耐量异常（IGT）39.0%,分别高于非冠心病组的61.6%、36.0%和20.7%,两组差异有统计学意义（P=0.006）。logistic回归分析提示,冠心病组患者存在糖耐量异常和新诊断糖尿病的风险分别是非冠心病组患者的1.6倍[OR=1.603,95%CI（1.023,2.512）,P=0.04]和2.3倍[OR=2.292,95%CI（1.391,3.777）,P=0.001],在纠正高血压、血脂异常、BMI、hs-CRP等因素后,冠心病组患者存在新诊断糖尿病风险仍较非冠心病组患者明显升高[OR=1.852,95%CI（1.064,3.223）,P=0.029]。结论未诊断糖尿病的冠心病住院患者普遍存在糖代谢异常,这些患者大部分需要通过OGTT检查才能及时准确地诊断。OGTT应该作为发现冠心病住院患者糖代谢异常的常规检查项目,如可能,全部心血管住院患者均应常规行OGTT检查。     

空腹血糖及糖化血红蛋白用于筛查糖耐量减退的比较性研究

目的比较空腹血糖（FPG）和糖化血红蛋白（HbAlc）在筛查糖耐量减退（IGT）中的应用价值。方法到我院门诊为明确有无血糖异常而就诊者336人，测定空腹血糖、糖化血红蛋白，并行口服葡萄糖耐量试验（OGTT）。结果按照1999年WHO的DM诊断标准，本研究人群空腹血糖〈6．1者124例，≥6．1-〈7．0者56例，≥7．0者156例；糖化血红蛋白〈6．1者84例，≥6．1者252例；OGTT2 hPG〈7．8者92例，≥7．8-〈11．1者99例，≥11．1者145例。结论糖化血红蛋白和空腹血糖均不适用于筛查IGT人群，但糖化血红蛋白比空腹血糖提示病人是否存在血糖异常更敏感。     

糖化血红蛋白在妊娠糖尿病诊断中的应用价值

目的探讨糖化血红蛋白对诊断妊娠糖尿病的意义。方法取2011年7月至2012年6月苏州市立医院确诊为妊娠糖尿病的患者87例,正常妊娠者100例,健康女性60例对其进行口服糖耐量试验(OGTT)、糖化血红蛋白检测。结果妊娠糖尿病患者糖化血红蛋白阳性率为34.5%。结论糖化血红蛋白不能单独用于妊娠糖尿病的筛查及诊断,对妊娠糖尿病血糖控制的评价具有重要的临床意义。     

High prevalence of undiagnosed impaired glucose regulation and diabetes mellitus in patients scheduled for an elective coronary angiography

Summary Background Impaired glucose regulation (IGR) and diabetes mellitus (DM) are amongst the main risk factors for developing coronary heart disease (CHD). The aim of this study was to investigate previously unknown glucose metabolism disorder in patients scheduled for an elective coronary angiography. Methods A total of 141 patients scheduled for coronary angiography without signs of acute myocardial ischemia or previous history of a glucose metabolism disorder were prospectively included in the study. An oral glucose tolerance test (OGTT) was performed in each patient. Results IGR was diagnosed in 40.4% (95% confidence interval 32.3–49.0) and undetected DM in 22.7% (16.1–30.5) of patients undergoing an elective coronary angiography. Depending on the severity of CHD, the percentage of IGR and DM increased up to 45.3% (34.6–56.5) and 26.7% (17.8–37.4) in the subgroup with the need of percutaneous angioplasty, while the corresponding proportions in the group without CHD were 30.3% (15.6–48.7) and 12.1% (3.4–28.2). The percentage of undiagnosed DM increased with the number of epicardial vessels involved. Using the recommended fasting plasma glucose value of ≥ 126 mg/dl for the diagnosis of DM, we would have missed 71.9% of the patients with undiagnosed DM. If all patients with a fasting plasma glucose of ≥ 90 mg/dl had been subjected to OGTT, 93.8% of DM would have been identified. Conclusions Prevalences of DM and IGR are higher than expected in patients with CHD. An OGTT should be considered for all patients with a fasting plasma glucose ≥ 90 mg/dl undergoing a coronary angiography.     

2012～2013年合肥地区孕妇OGTT筛查结果分析

目的：调查合肥地区孕妇妊娠期糖代谢异常的发生率,探讨其相关高危因素,以及孕妇在妊娠期进行口服葡萄糖耐量试验（OGTT）筛查的意义。方法以1520例2012～2013年于该院门诊就诊的妊娠前无糖尿病、高血压、心脏病、肾脏疾病、血液系统疾病及其他系统疾病的孕妇为研究对象,进行75 g OGTT筛查,结合临床相关资料分析合肥地区孕妇妊娠期糖代谢异常发生的相关高危因素。结果1520例孕妇75 g OGTT筛查阳性率为5．78％,其中葡萄糖耐量降低发生率为2．50％,妊娠糖尿病（GDM）检出率为3．28％。高龄、孕前肥胖及糖尿病家族史为妊娠期孕妇糖代谢异常的相关高危因素。结论对孕妇进行OGTT筛查能够有效发现GDM高危孕妇,并可及早预防和减少GDM的相关并发症。     

1157例体检者空腹血糖及糖耐量分析

目的 对1 157例体检者空腹血糖及糖耐量分析,掌握该区居民的血糖及其代谢情况.方法 采用人口成比例抽样(PPS)的方法,按经济条件分成3个层次,随机抽取1 157例研究对象采用葡萄糖氧化酶法测定空腹血糖,其中926例口服75 g无水葡萄糖2 h后测量血糖.结果 共计检出高血糖患者198例,检出糖耐量受损者117例,占12.63%,糖尿病患病率则为4.86%.结论 该区糖尿病患者及潜在者形势严峻,该区当前糖尿病防治应以经济较好的市区为重点向开发区辐射直至全区.     

氯氮平对长期住院精神分裂症患者糖代谢的影响

目的调查氯氮平对长期住院的精神分裂症患者糖代谢的影响。方法根据空腹静脉和餐后2 h静脉血糖水平,对服用氯氮平的长期住院男性精神分裂症患者进行糖尿病及与糖尿病相关状态的诊断。结果 67例患者中20例患者有糖尿病(29.8%),16例有糖耐量减低(IGT)(23.9%),6例有空腹血糖损害(IFG)(9%),25例为血糖代谢正常者(37.3%)。根据氯氮平剂量、体质指数和服药时间的不同将患者各分成3组,3组间的糖代谢异常发生率差异无统计学意义。正常组、IFG组、IGT组以及糖尿病组患者在胆固醇水平、体质指数、氯氮平剂量、三酯甘油水平以及服药时间之间差异无统计学意义。在IFG组,体质指数与患者每天氯氮平服用剂量之间呈显著性正相关(r=0.889,P=0.019),而在IGT组,各临床资料之间无明显相关性。结论长期服用氯氮平对精神分裂症患者糖代谢有明显影响。     

妊娠期糖尿病糖耐量试验的数据特点及临床意义

目的探讨妊娠期糖尿病糖耐量试验的特点。方法选择2009年1月至2009年10月在我院行产前检查并常规行50g GCT的孕妇682例,对筛查结果阳性者219例再行75g葡萄糖耐量试验（OGTT）,诊断妊娠期糖尿病（GDM）31例,糖耐量减低（GIGT）47例,分析GDM和GIGT的OGTF四点血糖值特点。结果GDM组平均年龄30．6岁;GIGT组平均年龄28．8岁。两组年龄比较P〈0．05。GDM组0、1、2、3h点血糖异常率分别是：0％、80．6％、90．3％和48．4％,以1h和2h点异常为主,占GDM诊断依据的71％;GIGT组0、1、2、3h点血糖异常率分别是：0％、21．3％、42．6％和36．1％,以2h和3h点异常为主,占GDM诊断依据的78．7％。结论GDM和GIGT发生与孕妇年龄有关,两种疾病可能有不同致病机理。GIGT可能主要是胰岛素储备功能不足,后续分泌下降引起,而GDM可能主要是胰岛素峰值分泌不足,部分兼具胰岛素储备功能不足后续分泌下降引起。     

糖化血红蛋白和血糖水平检测对精神病患者并发糖尿病的诊断价值

目的探讨糖化血红蛋白(HbA1c)、空腹血糖(FPG)、葡萄糖耐量试验(OGTT)2 h血糖检测对精神病并发糖尿病诊断的临床价值。方法收集重庆市精神卫生中心歌乐山院区老年科及综合科107例精神病并发糖尿病患者纳入观察组,110例非糖尿病的精神病患者纳入疾病对照组,100例职工健康体检者纳入健康对照组。采集血清及抗凝全血标本,采用己糖激酶法测定FPG、OGTT 2 h血糖,采用液相色谱离子交换层析法检测HbA1c水平,比较3组研究对象各项指标水平,并分析观察组各项指标相关性及并发症发生情况。结果观察组患者的FPG、OGTT 2 h血糖、HbA1c水平均明显高于疾病对照组和健康对照组,差异有统计学意义(P<0.05);疾病对照组和健康对照组的FPG、OGTT 2 h血糖、HbA1c水平比较,差异无统计学意义(P>0.05)。观察组中,FPG与HbA1c呈显著正相关(r=0.591,P<0.05);OGTT 2 h血糖水平与HbA1c水平呈显著正相关(r=0.564,P<0.05)。HbA1c>8%患者相关并发症的发生率均明显高于HbA1c≤8%患者,差异有统计学意义(P<0.05)。结论FPG、OGTT和HbA1c水平检测可作为诊断精神病患者并发糖尿病的一项重要指标,且对并发症发生风险具有重要的评估价值。     

Point‐of‐care Glucose and Hemoglobin A1c in Emergency Department Patients without Known Diabetes: Implications for Opportunistic Screening

Objectives: The objectives were to evaluate the correlation between random glucose and hemoglobin A1c (HbA1c) in emergency department (ED) patients without known diabetes and to determine the ability of diabetes screening in the ED to predict outpatient diabetes. Methods: This was a cross‐sectional study at an urban academic ED. The authors enrolled consecutive adult patients without known diabetes during eight 24‐hour periods. Point‐of‐care (POC) random capillary glucose and HbA1c levels were tested, as well as laboratory HbA1c in a subset of patients. Participants with HbA1c ≥ 6.1% were scheduled for oral glucose tolerance test (OGTT). Results: The 265 enrolled patients were 47% female and 80% white, with a median age of 42 years. Median glucose and HbA1c levels were 93 mg/dL (interquartile range [IQR] = 82–108) and 5.8% (IQR = 5.5–6.2), respectively. The correlation between POC and laboratory HbA1c was r = 0.96, with mean difference 0.33% (95% confidence interval [CI] = 0.27% to 0.39%). Glucose threshold ≥ 120 mg/dL had 89% specificity and 26% sensitivity for predicting the 76 (29%) patients with abnormal HbA1c; ≥ 140 mg/dL had 98% specificity and 14% sensitivity. The correlation between random glucose and HbA1c was moderate (r = 0.60) and was affected by age, gender, prandial status, corticosteroid use, and current injury. Only 38% of participants with abnormal HbA1c returned for OGTTs; 38% had diabetes, 34% had impaired fasting glucose/impaired glucose tolerance, and 28% had normal glucose tolerance. Conclusions: ED patients have a high prevalence of undiagnosed diabetes. Although screening with POC random glucose and HbA1c is promising, improvement in follow‐up with confirmatory testing and initiation of treatment is needed before opportunistic ED screening can be recommended.     

老年人糖代谢异常与颈动脉内中膜厚度关系及干预疗效

目的探讨老年人糖代谢异常与颈动脉内中膜厚度（IMT）的关系、影响IMT的因素及阿卡波糖干预效果。方法选择150例60岁以上无明确糖尿病病史但有糖尿病高危因素的老年人作为研究对象,行标准75 g口服葡萄糖耐量试验（OGTT）,按结果分为糖耐量正常（NGT,n=42）、糖调节受损（IGR,n=64）和糖尿病（DM,n=44）3组,同时测定各组生化指标,采用超声检查测定颈总动脉、颈内动脉和颈动脉分叉处IMT并了解血管壁情况。其中IGR组经生活干预半个月后随机分为两组：单纯生活干预组（n=32）;生活干预＋阿卡波糖组（n=32）;各组随访半年。半年后颈动脉超声复查颈总动脉、颈内动脉和颈动脉分叉处内IMT。结果 IGR及DM组颈总动脉、颈内动脉、颈动脉分叉处IMT值、斑块检出率显著高于NGT组（P〈0.05）;IGR药物干预组较IGR单纯生活干预组颈总动脉、颈内动脉、颈动脉分叉处IMT值、斑块检出率降低（P〈0.01）。Logistic回归分析显示,年龄、总胆固醇、甘油三酯、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平是IMT增厚的独立危险因素。结论与NGT组比较,IGR组存在明显的动脉粥样硬化表现,其程度与DM患者接近,表明动脉粥样硬化改变早在糖耐量低减阶段就已开始,早期药物干预有助于延缓动脉硬化的发展。     

妊娠早期空腹血糖测定结果回顾性分析

目的 探讨妊娠早期空腹血糖（FPG）测定水平与妊娠中期75g葡萄糖口服糖耐量试验（OGTT）结果 的关系。方法 选取2012年8月至2013年4月在孕12周时来该院建立孕册行空腹血糖检测,并于24～28周行75g葡萄糖OGTT试验的孕妇1107例,对其临床资料进行回顾性分析。以国际妊娠合并糖尿病研究组（IADPSG）2010年提出的新诊断标准按OGTT结果 将孕妇分为4组。A组为OGTT结果 正常组,B组为OGTT结果 有1项异常,C组为OGTT结果 有2项异常,D组为OGTT结果 有3项异常。比较4组孕妇空腹血糖结果 的差异。结果 A、B、C、D组的孕早期空腹血糖均值呈递增变化,A组孕早期FPG≥5．1mmol／L的孕妇有65例占5．9％（65／1107）,OGTT异常组有7例孕妇早期FPG≤4mmol／L。结论 孕早期空腹血糖升高是预警信号,提示孕中期发生妊娠糖尿病（GDM）的可能性增大。但将孕早期FPG≥5．1mmol／L作为GDM的诊断标准尚存疑问。处于任何一个空腹血糖区间,均有可能发生糖耐量异常,设立1个空腹血糖值而排除GDM的方法 不准确。     

糖耐量异常与脑梗死患者颅内外动脉粥样硬化的相关性研究

目的探讨糖耐量异常的脑梗死患者颅内外动脉粥样硬化的程度及其相关危险因素。方法选择脑梗死患者131例,通过口服葡萄糖耐量试验（OGTT）将患者分为糖耐量正常组（NGT,n=41例）、糖耐量异常组（IGT,n=47例）、新诊断的2型糖尿病组（DM,n=43例）。测定各项生化指标,进行颈部血管彩色超声、经颅多普勒检查,记录颅内外动脉狭窄数、颈总动脉内中膜厚度（IMT）及其他指标。结果 IGT组及DM组的双侧颈动脉IMT平均值（MIMT）、阻力指数、斑块积分和内膜不连续比率、颅内外动脉狭窄率与NGT组相比差异均有统计学意义（P〈0.05）,而IGT组与DM组相比无统计学意义。Logistic回归显示,餐后2h血糖（2h-PG）（OR=1.995,P=0.004）、糖化血红蛋白（HbA1c）（OR=4.799,P=0.028）、甘油三酯（TG）（OR=7.439,P=0.012）及伴随疾病（高血压）（OR=8.639,P=0.042）均为异常IMT的独立危险因素。颅内外动脉闭塞性病变的多因素回归分析显示,2h-PG、低密度脂蛋白（LDL-C）及收缩压为其危险因素（OR值与P值分别为1.762、0.002,1.189、0.048,1.231、0.014）。结论餐后高血糖是动脉粥样硬化的独立危险因素,早在糖耐量异常阶段就已经发生了颅内和颅外大血管的动脉粥样硬化,提示糖耐量异常也是脑梗死的危险因素。     

阿卡波糖早期干预治疗对合并糖耐量减低的冠心病患者的影响

目的:探讨阿卡波糖早期干预对糖耐量减低的冠状动脉粥样硬化性心脏病(冠心病)患者的影响。方法:冠心病合并糖耐量减低的177例患者均予常规冠心病治疗,并随机分为阿卡波糖组(93例,加阿卡波糖50 mg,3次/日),生活干预组(84例,加饮食控制加运动),临床随访2年,观察两组患者胰岛素抵抗指数(HOMA-IR),胰岛β细胞功能(HOMA-β),血糖及心血管事件发生率等。结果:治疗后阿卡波糖组与生活干预组比较,Homa IR下降明显,HOMA-β升高明显(P均<0.05);转化为2型糖尿病百分率较少(3%对比15%,P<0.05);总心血管事件发生率较低(5%对比15%,P<0.05)。结论:对合并糖耐量减低的冠心病患者早期予阿卡波糖干预治疗,可改善胰岛素抵抗和β细胞功能,降低2型糖尿病发生率,并降低心血管事件风险。     

急性冠状动脉综合征患者口服糖耐量试验检查时机选择

目的探讨急性冠状动脉综合征（ACS）患者口服糖耐量试验（OGTr）的检查时机与安全性。方法选择2007年1月至2012年1月232例ACS住院患者,于病情稳定后及出院后3个月随访时行OGTr,并注意患者心电图和症状变化。结果病情稳定后于出院前OGTT检查发现血糖正常占40．95％（95／232）、糖尿病25．00％（58／232）、糖耐量减低34．05％（79／232）、空腹血糖受损2．59％（6／232）,与出院后3个月[血糖正常占39．91％（89／215）,糖尿病22．33％（48／215）,糖耐量减低33．95％（73／215）,空腹血糖受损2．33％（5／215）]比较差异均无统计学意义（x2值分别为0．051、0．441、0．001、0．032,P均〉0．05）,心电图sT段比较差异亦无统计学意义[（-0．12±0．08）mV与（-0．15±0．12）mV,t=0．23,P=0．85）。OGTr检查时不良反应少。结论ACS患者为糖代谢异常的高危人群,病情稳定后行OGTT是安全的,对于ACS患者都应常规行OGTT,及早发现糖代谢异常患者,并进行相应干预及治疗。