葡萄糖负荷试验在急性冠脉综合征中的作用

The Role of Oral Glucose Tolerance Test in Patients with Acute Coronary Syndrome

目的研究葡萄糖负荷试验在急性冠脉综合征(ACS)中的作用。方法入选124例ACS患者,男性69例,女性55例,病情平稳后行75g葡萄糖负荷试验(OGTT)和胰岛素释放试验,根据负荷后2h血糖值分为血糖正常组、糖调节异常组、糖尿病组,分析糖负荷后2h血糖值和胰岛素抵抗的作用。结果(1)急性冠脉综合征患者中新诊断糖尿病患病率为16.9%,糖调节受损患病率为22.58%,总的糖代谢异常患病率为39.51%。(2)糖调节异常组和糖尿病组空腹胰岛素水平升高,与血糖正常组比较存在胰岛素抵抗(P<0.01)。结论仅仅依靠检测空腹血糖,将漏诊ACS中的部分葡萄糖代谢异常患者;对ACS患者进行葡萄糖负荷试验是必要的;葡萄糖代谢异常者存在不同程度的胰岛素抵抗。

Objective To study the role of oral glucose tolerance test in patients with acute coronary syndrome. Methods To study the role of postchallenge 2 hours glucose and insulin resistance （IR） in patients with acute coronary syndrome. The total of 124 patients （69 males and 55 females） which were suffered from acute coronary syndrome were divided into three groups （euglycemia group, impaired glucose tolerance group, diabetes group） according to oral glucose tolerance test （OGTT） . Results The new prevalence of patients with DM and impaired glucose regulation were 16.90% and 22. 58% inpatient with ACS, respectively. The total prevalence of abnormal glucose metabolism was 39. 51%. Compared with euglycemia group, the level of fasting insulin were more significant than impaired glucose tolerance group and diabetes group （P〈0. 01 respectively）. The results showed that there were insulin resistance in impaired glucose tolerance group and diabetes group （P〈0. 01 respectively）. Conclusion Some of patients with abnormal glucosemetabolism would have remained undiagnosed only depend on the level of fasting glucose. It is imperative and necessary for patients with ACS to take oral glucose tolerance test. There are varying degrees of insulin resistance in patients with abnormal glucosemetabolism.