重症冠心病患者应激高血糖与糖化血红蛋白的研究

目的 比较不同危重冠心病患者的应激高血糖和糖化血红蛋白（HbA1c）的差异.方法 回顾性分析237例危重冠心病患者的应激高血糖和糖化血红蛋白.按照诊断不同分为AHF、AMI、NSTEMI、ACS 4组,比较人院时AHF、AMI、NSTEMI、ACS 4组患者血糖水平的差异性,比较糖化血红蛋白的差异性.按照糖化血红蛋白水平再将AHF、AMI、NSTEMI、ACS患者分为A组（HbA1c ＜6.5％）、B组（HbA1 c≥6.5％）,比较A组、B组的应激血糖水平.结果 AHF、AMI、NSTEMI、ACS 4组患者的应激血糖比较差异有统计学的意义（F=15.156,P＜0.01）,AHF的应激血糖水平最高.AHF、AMI、NSTEMI、ACS 4组患者的糖化血红蛋白比较差异没有统计学意义（F=0.137,P＞0.05）.A组、B组间比较AHF、AMI、NSTEMI患者应激血糖比较差异有统计学意义（P＜0.05）,A组、B组间比较ACS患者应激血糖比较差异无统计学意义.结论 AHF、AMI、NSTEMI、ACS 4组患者间以AHF的应激血糖水平最高,但他们的糖化血红蛋白水平一致.AHF、AMI、NSTEMI、ACS患者中B组较A组的应激血糖水平高.

Study of Stress Hyperglycemia and Glycated Hemoglobin in Severe Patients with Coronary Heart Disease

Objective To study the difference of stress hyperglycemia and glycated hemoglobin among critically ill patients with coronary artery disease.Methods The data of stress hyperglycemia and glycated hemoglobin were retrospectively analyzed on 237 patients with coronary artery disease.The patients were divided into four groups of AHF,AMI,NSTEMI,ACS.The difference of stress hyperglycemia and glycated hemoglobin were compared among the four groups.The four groups of AHF,AMI,NSTEMI,ACS were further divided into A group （HbA1c ＜ 6.5％） and B group（HbA1c≥6.5％） according to the level of glycated hemoglobin.The level of stress hyperglycemia were compared between A and B groups.Results The comparison of stress hyperglycemia among AHF,AMI,NSTEMI,ACS groups were statistically significant （F =15.156,P ＜ 0.01）.The level of stress hyperglycemia of AHF group was the highest.The glycated hemoglobin among AHF,AMI,NSTEMI,ACS groups were no statistically significant difference （F =0.137,P ＞ 0.05）.The level of stress hyperglycemia of AHF,AMI,NSTEMI patients were statistically significant （P ＜ 0.05） between A and B groups,while the level of stress hyperglycemia of ACS patients were not statistically significant （P ＞ 0.05）.Conclusion The level of stress hyperglycemia of AHF group was the highest among the AHF,AMI,NSTEMI,ACS groups,while the level of their glycated hemoglobin was consistent.The level of stress hyperglycemia of group B was higher than group A within AHF,AMI,NSTEMI,ACS patients.