应激性高血糖对非糖尿病急性心肌梗死预后的影响

THE IMPACT OF STRESS-INDUCED HYPERGLYCEMIA ON NON-DIABETIC ACUTE MYOCARDIAL INFARCTION

目的探讨应激性高血糖对非糖尿病急性心肌梗死(AMI)预后的影响。方法选取2014年10月—2015年10月收治的AMI合并应激性高血糖的非糖尿病患者77例作为观察组,选取60例同期收治的急性心肌梗死未合并应激性高血糖患者作为对照组,记录二组患者入院后实验室检查CK-MB、ultra-nI、NT-proBNP结果,记录二组患者中心力衰竭、心律失常和死亡的发生率,并进行对比分析。结果观察组患者CK-MB、ultra-TnI和NT-proBNP水平均明显高于对照组,差异有统计学意义(P<0.05);观察组患者心力衰竭、心律失常、死亡的发生率均明显高于对照组,差异有统计学意义(P<0.05);心功能参数的比较观察组患者左心室射血分数(LVEF)显著低于对照组,而左心室舒张末期内径(LVDd)和左心室收缩期末期内径(LVDs)则显著高于对照组,差异均有统计学意义(P<0.05)。结论应激性高血糖导致非糖尿病AMI患者心肌功能损伤加重,预后可能更差。

Objective to detect the impact of stress- induced hyperglycemia on non diabetic acute myocardi- al infarction. Methods Seventy-seven patients with non- diabetic AMI incorporating stress hyperglycemia were chosen as the research group in author＇s hospital from October 2014 to October 2015, another 60 cases with non-diabetic AMI unincorporating stress hyperglycemia were chosen as the control group. The laboratory results of CK- MB, ultra-nI, NT- proBNP and the incidence of heart failure, arrhythmia and mortality were compared and analyzed between the two groups. Results The level of CK - MB,ultra- TnI and NT-proBNP in the research group were higher than that in the control group, the differences were statistically significant （P〈0.05）. Compared with the control group, there was not increase in the incidence of heart failure, arrhythmia and mortality in the research group, the differences were statistically significant （P〈0.05）. The LVEF of the research group patients was lower,but the LVDd and LVDs were higher than the control group,the differences were statistically significant（P〈0. 05）. Conclusion Stress - induced hyperglycemia can aggravate the cardiac function in patients with non-diabetic AMI and whose prognosis will also be worse.