应激性血糖升高及超敏C反应蛋白检测在急性心肌梗死患者中的临床意义

目的 研究应激性血糖升高和超敏C反应蛋白检测对急性心肌梗死患者近期预后的影响及意义.方法 对2009年9月至2011年7月127例既往无糖尿病病史的急性心肌梗死患者进行分析,记录基本临床资料,检测血糖及超敏C反应蛋白水平,以空腹血糖>7.0 mmol/L划分为有应激性高血糖组(n=65)和<7.0 mmol/L为无应激性高血糖组(n=62)两组,平均随访30 d,比较两组间冠脉病变、心力衰竭、心律失常及院内病死率的发生率.结果 伴有应激性血糖增高组的急性心肌梗死患者伴更高的超敏C反应蛋白水平,且多支冠脉病变及非Q波心肌梗死发生率高于血糖正常组(P<0.05),心力衰竭、心律失常及死亡的发生率明显高于血糖正常组(P<0.01).结论 应激性血糖升高及高水平的超敏C反应蛋白是急性心肌梗死患者不良预后的危险因素,有更高的心力衰竭、心律失常及死亡的发生率.

Clinical significance of stress hyperglycosemia and high-sensitivity C-reactive protein in patients with acute myocardial infarction

Objective To research the effect of the prognostic significance of stress blood glucose rise to the patients with acute myocardial infarction and the relation between blood glucose and high-sensitivity c-reactive protein.Methods To analysis 127 cases who had no history of diabetes in patients with acute myocardial infarction during September 2009 to July 2011.Record basic clinical data,blood glucose and high-sensitivity c-reactive protein levels,mean follow-up 30 days,compared between the two groups of coronary disease,heart failure,arrhythmia and the incidence of hospital mortality.Results During follow-up,hyperglycemia and high hs-CRP had more risks in congestive heart failure and arrhythmia than normal glucose group did（P〈0.05）.Conclusion Stress hyperglycaemia and high hs-CRP in patients with myocardial infarction is associated with an increased risk of in-hospital mortality and congestive heart failure,arrhythmia.