血糖控制对急性心肌梗死患者C反应蛋白及近期预后的影响

目的探讨伴2型糖尿病的急性心肌梗死患者血糖控制情况对高敏c反应蛋白（hs—CRP）水平及住院期间不良心血管事件产生的影响。方法110例急性心肌梗死患者分为3组，I组为不伴糖尿病组，Ⅱ组为伴2型糖尿病且血糖控制良好组，Ⅲ组为伴2型糖尿病且血糖控制不良组。观察3组患者既往糖化血红蛋白水平、入院后hs—CRP水平及不良心血管事件发生。结果Ⅱ组和Ⅲ组患者hs-CRP水平分别为（7．21±1．37）mg／L、（9．48±1．10）mg／L，明显高于I组（3．56±1．72）mg／L，差异有统计学意义（均P〈0．01）。I组、Ⅱ组和Ⅲ组不良心血管事件发生概率分别为13．5％（7／52）、31．6％（12／38）和60．0％（12／20），Ⅱ组与I组比较P〈0．05，Ⅲ组与Ⅰ组比较P〈0．01。结论血糖控制不良可抬高伴2型糖尿病的心肌梗死患者hs—CRP水平，伴2型糖尿病的冠心病患者控制血糖可改善发生心肌梗死后的近期预后。

The influence of blood glucose control on C reactive protein and short-term prognosis in acute myocardial infarction patients

Objectives To study the influence of blood glucose control on high sensitive C reactive protein (hs-CRP) and serious cardiovascular events in acute myocardial infarction patients in hospital. Methods The level of former HbAlc, hs-CRP and serious cardiovascular events were observed in one hundred and ten acute myocardial infarction patients with or without type 2 diabetes. Results The acute moycardial infarction patients with type 2 di-abetes showed a higher level of hs-CRP than these patient without type 2 diabetes(P <0.01). These patients with type 2 diabetes with a bad blood glucose control had a higher level of hs-CRP than these with a good glucose control.The acute moycardial infarction patients with type 2 diabetes also showed a high probability of serious cardiovascular events(with a good glucose control group, P < 0.05; with a bad glucose control group, P < 0.01). The patients with type 2 diabetes with a bad blood glucose control has a higher probability of serious cardiovascular events than these with a good glucose control(P<0.05). Conclusions A bad blood glucose control can increase the level of hs-CRP in acute myocardial infarction patients with type 2 diabetes, but a good glucose control can improve short-term prognosis of coronary heart disease patients with type 2 diabetes after acute myocardial infarction.