急性冠脉综合征患者30d心力衰竭与入院血糖水平的关系

Association between the risk of heart failure and admission glucose level in patients with acute coronary syndromes at 30 days

目的探讨急性冠脉综合征(ACS)患者发病30d时发生心力衰竭(HF)与入院血糖水平之间的关系。方法 255例首次发生ACS患者,根据患者入院时血糖的四分位数6.9,8.5,10.2mmol/L分为Ⅰ组(n=61),Ⅱ组(n=63),Ⅲ组(n=67)及Ⅳ组(n=64)4组,分析ACS患者发病30d时发生HF的危险因素。结果 255例患者中59例发病30d时发生HF,发生率为23.6%。随着入院血糖水平的升高,4组患者间年龄、糖尿病史、Killip分级≥Ⅱ级、左室射血分数、高敏C反应蛋白的差异具有显著性(P<0.01)。高血糖能预测ACS患者近期HF的发生。随着血糖的增高,发生HF的危险性增大。结论入院血糖水平是ACS患者短期HF发生的独立预测因素。

Objective To evaluate the relation between heart failure and admission glucose level in Patients with acute coronary syndromes at 30 days. Methods A total of 255 patients with first ACS were stratified into quartile groups（ Ⅰ to Ⅳ ） defined by serum glucose concentrations of 6. 9,8.5 ,and 10. 2 mmol/L. The relation between quartile group and HF in Patients with ACS at 30 days were analyzed. Results The cases of HF with ACS at 30 day were found in 59 （23.6%）of 255 patients. The proportion of patients with ages, known diagnosis of diabetes mellitus, Killip class ≥ Ⅱ ,left ventricle ejection fraction, high sensitive c-reactive protein were demonstrated（ P 〈 0.01 ）. Hyperglycemia could predict the happen of HF. The odds of HF increased incrementally across the quartile groups. Conclusion Blood glucose level was an independent prognostic factor for HF in patients with ACS at 30 day.