摘要
目的探讨急性冠状动脉综合征(acute coronary syndrome,ACS)患者应激性高血糖对血浆脂联素水平及左心室重构的影响。方法入选80例无糖尿病史的ACS患者,其中应激性高血糖患者(stress hyperglycemia,SH)38例,非SH者42例。检测患者入院第2日的空腹血糖,发病72小时血浆脂联素水平;分别于发病第2周、3个月时进行超声心动图检查,测量左心室舒张末容量指数(LVEDVI)、左心室收缩末容量指数(LVESVI)、左心室射血分数(LVEF),并随访3个月。结果SH组较非SH组血浆脂联素浓度显著降低,(3.70±1.59)mg/L vs(5.56±1.85)mg/L(P<0.01),3个月LVEDVI和LVESVI明显增大,4.22±2.63 vs 2.49±2.70(P<0.05);1.84±1.73 vs0.32±1.83(P<0.01),主要不良事件发生率明显增高:(31.58%vs 19.05%,P<0.05)血浆脂联素水平与空腹血糖水平呈显著负相关(r=-0.414,P<0.001)与LVEDVI及LVESVI3个月变化值呈显著负相关(r=-0.308,-0.267,均P<0.05)。结论SH组ACS患者血浆脂联素水平显著低于非SH患者,且血糖水平和血浆脂联素水平呈显著负相关,说明ACS患者应激状态对血浆脂联素水平降低有影响,并进一步影响左心室重构及预后。
Objective To explore the effect of stress hyperglycemia on plasma concentration of adiponectin and left ventricular remodeling in patients with acute coronary syndrome(ACS). Methods Eighty non-diabetic patients with ACS were enrolled in this study. There were 38 cases in the stress hyperglycemia(SH) group,and 42 cases in the non stress hyperglycemia(non SH) group. The fasting plasma glucose(FPG) was detected on the second day after admission. The plasma concentration of adiponectin was detected 72 hours after heart disease attack. Left ventricular end-diastolic volume index(LVEDVI),left ventricular end systolic volume index(LVESVI) and left ventricular ejection fraction(LVEF) were respectively measured by echocardiography in two weeks and three months after disease attack. All cases were followed up for three months. Results Compared with that in non SH group,the plasma concentration of adiponectin in SH group was significantly lower, (3.70± 1.59) mg/L vs (5.56±1.85) mg/L( P 〈0.01) ,LVEDVI and LVESVI in SH group increased significantly,4.22±2.63 vs 2.49±2.70 ( P 〈0.05) ;1.84±1.73 vs 0.32±1.83 ( P 〈0.01) ,and the incidence of major adverse events was significantly higher (31. 58% vs 19.05%, P 〈0.05). There was a significant negative correlation between plasma adiponectin concentration and FPG level( r =--0. 414, P 〈 0.01). The plasma concentration of adiponectin was also negatively correlated with the diameter of LVEDVI and LVESVI changed in three months ( r = --0. 308,--0. 267, both P 〈0.05). Conclusion The plasma concentration of adiponectin in SH patients is significantly lower than that in non SH patients, FPG level and plasma adiponeetin level are negatively correlated. It demonstrates that,in patients with ACS,stress statue has effect on plasma concentration of adiponectin,and even impacts on the left ventricular remodeling and prognosis.
出处
《临床荟萃》
CAS
2009年第15期1302-1304,共3页
Clinical Focus
关键词
冠状动脉疾病
应激
高血糖症
心室重构
脂联素
coronary disease
stress
hyperglycemia
ventricular remodeling
adiponectin