急性冠脉综合征患者血糖变异性与冠脉病变程度相关性研究

Related study of correlation between glucose variability and the severity of coronaryartery disease in patients with acute coronary syndrome

目的:比较合并糖尿病的急性冠状动脉综合征(ACS)患者和无糖尿病ACS患者临床特点的差异,并研究ACS患者住院期间血糖变异性与冠脉狭窄程度相关性。方法:急性冠状动脉综合征(ACS)160患者分为合并糖尿病ACS80例(A组)和无糖尿病ACS患者80例(B组)。观察两组ACS患者基线时各指标、临床特点、住院期间不良事件发生情况以及血糖的变异系数及多元逐步回归分析冠脉病变严重程度(指标为gensini狭窄分数)的相关因素。结果:A组患者高血压、高密度脂蛋白、胆固醇、HDL-C、纤维蛋白原较B组有显著性差异(P均<0.05);A组冠脉狭窄、住院期间不良事件发生率明显高于B组(P均<0.05);多元回归分析显示糖尿病、高血压病程、HDL-C、平均血糖水平、血糖变异系数与死亡率呈显著相关。结论:血糖变异性大均提示冠状动脉病变程度重、近期预后不良。

Objective To compare the characteristics,management and outcomes of diabetic and nondiabetic patients with acute coronary syn drome（ACS）,and to study the correlation between glucose variability and the severity of coronaryartery disease.Methods 160 cases with ACS divided into diabetic patients 80 case（group A） and nondiabetic patients 80 cases（group B） with acute coronary syndrome（ACS）.The index of baseline indicators,clinical features,hospital adverse events as well as blood glucose variation and multiple stepwise regression analysis of the severity of coronary lesions related factors were observed in two groups with ACS.Results The high blood pressure,high density lipoprotein,cholesterol,HDL-C,fibrinogen in Group A with Group B were has significant difference（P0.05）;The incidence of coronary artery stenosis and adverse events in Group A was significantly higher than Bgroup（P0.05）;Multiple regression analysis showed that diabetes,duration of hyper tension,HDL-C,the average blood glucose levels and blood glucose variation,with mortality were significantly correlated.Conclusions High blood glucose variation suggests coronaryartery lesion and poor short-term prognosis.