应激性高血糖与不稳定型心绞痛的关系

目的：观察应激性血糖浓度变化与不稳定型心绞痛患者预后的关系。方法：选择符合不稳定型心绞痛诊断标准且有糖耐量异常患者236例,按入院时随机血糖数值分为两组：糖耐量减低组138例,糖尿病组98例;观察两组患者血糖的变化、一个月病情进展和死亡率。结果：治疗一个月过程中,糖耐量减低组心肌梗死发生率明显低于糖尿病组（1.4%比7.1%,x2=5.06,P〈0.05）,死亡率无明显差异（x2=0.23,P〉0.05）。结论：应激性高血糖一方面反映了机体的应激程度,另一方面可加重缺血心肌的损害;通过对患者的血糖监测,可在一定程度上评估患者的预后,指导治疗方案的调整。

Relationship between stress hyperglycemia and unstable angina pectoris

Objective:To investigate relationship between stress hyperglycemia and prognosis of patients with unstable angina pectoris(UAP).Methods:According to random blood glucose levels at admission,a total of 236 UAP patients with impaired glucose tolerance(IGT) were divided into IGT group(n=138) and diabetes mellitus group(DM group,n=98).Changes of blood glucose concentration,progression of disease and mortality rate in a month were observed and compared between the two groups.Results:During one-month treatment,compared with DM group,incidence rate of myocardial infarction was significantly lower(7.1% vs.1.4%,x2=5.06,P<0.05),but mortality rate was no significant different in IGT group(x2=0.23,P>0.05).Conclusion:Stress hyperglycemia reflects stress level of the organism and can aggravate damage of ischemic myocardium;monitoring blood glucose of patients can evaluate prognosis of patients to some extent and guide adjustment of clinical therapeutic plan.