急性心肌梗死患者应激性血糖升高及血清尿素氮变化的临床观察

A clinical observation of stress blood glucose rise and urea nitrogen change during acute myocardial infarction

目的探讨应激性血糖升高对急性心肌梗死（ＡＭＩ）患者预后的影响及ＡＭＩ患者血糖与血清尿素氮（ＢＵＮ）水平之间的关系。方法所有病例分为两组：血糖升高级（Ａ组）９７例，正常血糖组（Ｂ组）１０５例，对两组病例的临床资料及ＢＵＮ进行对比分析，糖尿病人被排除在本研究之外。结果（１）应激性血糖升高检出率为４８．０％（９７／２０２）；（２）血糖升高组的泵衰竭发生显著高于正常血糖组（Ｐ＜０．０５），病死率显著高于正常血糖组（Ｐ＜０．０１）；（３）血糖升高级的ＢＵＮ水平显著高于正常血糖组（Ｐ＜０．０５），异常ＢＵＮ检出率显著高于正常血糖组（Ｐ＜０．０５）。结论ＡＭＩ患者应激性血糖升高提示预后不良，把应激性血糖升高和ＢＵＮ结合起来用于判断ＡＭＩ的预后是有价值的。

Objective To research the effect of the prognostic significance of stress blood glucose rise to the patients with acute myocardial infarction (AMI) and the relation between blood glucose and blood urea nitrogen (BUN). Methods The patients with AMI were divided into two groups: Group A with rise blood glucose (97 cases), Group B with normal blood glucose level (105 cases ). Their clinical data and BUN were compared statisti- cally. In the study that the patients with diabetes were excluded. Results 1. The rate of rise blood glucose was 48. 0% (97/202). 2. The morbidity of pump failure in Group A was higher than that in Group B (P <0.05). The mortality in Group A was much higher than that in Group B (P<0.01). 3. BUN level in Group A was much higher than that in Croup B (P < 0.01). The detective rate of abnormal BUN in Group A was higher than that in Group B (P<0.05). Conclusion The stress blood glucose rise shows poor prognosis in the patients with AMI. The combination of stress rise blood glucose and BUN can be used to estimate the prognosis of AMI.