冠状动脉粥样硬化性心脏病患者糖代谢状况的调查分析

目的 通过对冠状动脉粥样硬化性心脏病(冠心病)患者口服葡萄糖耐量试验、糖化血红蛋白检测和对糖代谢状况的分析,探讨糖代谢异常与冠心病的关系.方法 选择2010年4～12月,贵阳医学院明确诊断的冠心病住院患者480例.分析冠心病患者糖代谢状况及糖化血红蛋白与口服葡萄糖耐量试验相关性.结果 480例冠心病患者,414例(86.25％)存在糖代谢异常,单纯测空腹血糖,新诊断的糖尿病中漏诊52.14％,糖代谢异常漏诊69.86％.346例未明确诊断糖尿病患者,糖化血红蛋白异常245例,占70.81％.与口服葡萄糖耐量试验检测出糖代谢异常比较无统计学意义(P＞0.05).346例未明确诊断糖尿病患者相关性分析表明,糖化血红蛋白与空腹血糖及口服葡萄糖耐量试验2h血糖成正相关,相关系数分别为r=0.446、r =0.732(P ＜0.05).结论 冠心病患者大部分合并糖代谢异常,应对冠心病患者常规行口服葡萄糖耐量试验及糖化血红蛋白检测,尤其可以将糖化血红蛋白作为糖调节受损简单易行的诊断标准,早期发现糖代谢异常,及早干预,防止糖尿病血管疾病的发生、发展.

Survey and analysis of Glucometabolic status in patients with coronary artery disease

【Objective】 The analysis of oral glucose tolerance test(OGTT),hemoglobin a1c(HbA1c) test,and glucometabolic status in patients with coronary artery disease,is aimed to assess the correlations between glucose metabolism disorders and coronary heart disease.【Methods】 The study selects 480 cases of inpatients with coronary heart disease diagnosed by the Affiliated Hospital of Guiyang Medical College from April to December 2010.A comparative analysis of glucometabolic status,and the correlation between HbA1c and OGTT is performed.【Results】 According to the research,414 cases(accounting for 86.25%) have abnormal glucose metabolism.In the simple fasting plasma glucose(FPG) test,the rate of missed diagnosis on preclinical diabetes mellitus(PDM) and sugar metabolism disorders is 52.14% and 69.86%,respectively.Among 346 cases who are not explicitly diagnosed with diabetes mellitus(DM),245 cases are found having abnormal hemoglobin a1c,accounting for 70.81%,which represents no statistically significant difference(P >0.05) compared with metabolic abnormalities detected in OGTT.The correlation analysis between glycated hemoglobin test and OGTT of undiagnosed 346 cases shows that,HbA1c is positively correlated to FBG and OGTT 2 h PBG,as is represented by correlation coefficient r =0.446(P <0.05),r =0.732(P <0.05),respectively.【Conclusions】 Most patients with coronary artery disease have abnormal glucose metabolism,and shall undergo conventional OGTT and HbA1c test.HbA1c can also be used as a simple standard to diagnose impaired glucose regulation for early detection of abnormal glucose metabolism and timely intervention,so as to prevent the occurrence and progression of DM vascular diseases.