急性心肌梗死与反应性高血糖

在急性心肌梗死患者中，合并反应性高血糖即应激性高血糖是非常普遍的，其显著增加住院期间患者死亡率。产生反应性高血糖的主要原因是激素调节异常和细胞因子的大量分泌以及胰岛素抵抗。高血糖主要是通过能量供需矛盾、纤溶失活、氧化应激及内皮功能失衡等机理影响患者近期预后，因此，一些研究提示反应性高血糖可作为急性心肌梗死患者近期预后不良的敏感、简便、直观的预测因子：现就近年来急性心肌梗死合并反应性高血糖的研究进展作一综述。

Stress-Induced Hyperglycemia in Acute Myocardial Infarction

Stress-induced hyperglycemia is common and associated with markedly increased mortality rates in patients hospitalized with acute myocardial infarction （AMI）. Potential mechanisms, mediators （e. g, hormones, cytokines） , and insulin resistance may play a key role in hyperglycemia during acute and prolonged phases of severe illness. Acute hyperglycemia is associated with numerous adverse effects that contribute to a poor outcome in AMI, such as increased oxidative stress, fibrinolysis inactivation, and endothelial dysfunction. So, stress hyperglycemia is an important, sensitive, and direct predictor for AMI in a 30-day prognosis. In this article we review the relationship between stress-induced hyperglycemia, and acute myocardial infarction.