冠状动脉搭桥术后应激性高血糖与术前糖化血红蛋白的关系研究

目的:探讨冠状动脉搭桥手术患者术后应激性血糖与术前糖化血红蛋(HbA1c)的关系。方法:回顾分析96例无糖尿病史且行心脏冠状动脉搭桥手术患者,术前完善了口服葡萄糖耐量(OGTT)试验除外糖尿病,根据HbA1c值分为相对高糖化组(HbA1c≥6.0%)和对照组(HbA1c<6.0%),观察2组术前基线指标和术后应激性血糖有无差异及相关性。结果:高糖化组与对照组术前年龄(P=0.001)、体质量指数(BMI)(P=0.007)、腰臀比(WHR)(P=0.0001)、胰岛素抵抗(HOMA-IR)指数(P=0.001)以及术后应激性血糖(P=0.0001)差异均有统计学意义;高糖化组术后应激性高血糖患者明显多于对照组(P=0.001),线性回归分析显示术前HbA1c值和应激性血糖密切相关(R2=0.224)。结论:术前超质量或腹型肥胖尤其是年龄大者,即使无糖尿病也应测定HbA1c,如果HbA1c≥6.0%应积极防治术后应激性高血糖。

Clinical investigation the relationship of stress-blood glucose and HbA1c in patients after coronary artery bypass

Objective:To investigate the relationship of stress-blood glucose and HbA1c in patients after coronary artery bypass.Methods:Ninty six patients with no diabetic history took standardized oral glucose tolerance test before surgical coronary artery bypass to rule out diabetes the basic blood glucose and stress-blood glucose,values were compared between HbA1c≥6.0% group and HbA1c<6.0% group.Results:Age(P=0.001),Body Mass Index(P=0.007),Waist-hip ratio(P=0.000),Insulin-resistance index(HOME-IR)(P=0.001) and Stress-blood glucose(P=0.000) values in the group(HbA1c≥6.0%) were all significantly higher than the control group(HbA1c<6.0%).HbA1c were significantly correlated to stress-blood glucose.(R2=0.224).Conclusion:HbA1c should be measured in the older patients with abdominal obesity before surgery in spite of no diabetes.If HbA1c was greater than or equal to 6.0%,prevention and treatment of stress-hyperglycemia should be taken.