LDL-C与急性心肌梗死合并应激性高血糖相关风险分析

Risk analysis of LDL-C and acute myocardial infarction combined with stress-induced hyperglycemia

目的探讨急性心肌梗死(AMI)患者血清低密度脂蛋白胆固醇(LDL-C)水平与应激性高血糖的相关性。方法入组自2016年6月至2018年12月期间就诊于天津医科大学总医院和天津市胸科医院的AMI患者共247例,根据有无糖尿病及是否发生应激性高血糖分为四组,非糖尿病应激性高血糖组(A组,65例),非糖尿病血糖正常组(B组,96例),糖尿病应激性高血糖组(C组,54例),糖尿病非应激性高血糖组(D组,32例),比较四组的临床特点并分析与LDL-C相关性。结果非糖尿病患者中,应激性高血糖组LDL-C显著高于血糖正常组[(3.29±1.09)mmol/L vs.(2.92±0.94)mmol/L,P<0.05];糖尿病患者中,应激性高血糖组LDL-C显著高于非应激性高血糖组[(2.99±0.85)mmol/L vs.(2.57±0.85)mmol/L,P<0.05]。多因素Logistic回归分析显示LDL-C为AMI发生应激性高血糖的独立风险因素(OR=1.957,95%CI:1.014~3.774,P<0.05)。结论LDL-C为AMI应激性高血糖的独立危险因素。

Objective To investigate the correlation between serum low-density lipoprotein cholesterol(LDL-C)levels and stress-induced hyperglycemia in patients with acute myocardial infarction(AMI).Methods A total of 247 patients with AMI who were admitted to Tianjin Medical University General Hospital and Tianjin Chest Hospital from June 2016 to December 2018 were enrolled.They were divided into four groups according to the presence or absence of diabetes and the occurrence of stress-induced hyperglycemia.Non-diabetic stress hyperglycemia group(group A,65 patients),non-diabetic normal hyperglycemia group(group B,96 patients),diabetic stress hyperglycemia group(group C,54 patients),high diabetic non-stress In the blood glucose group(group D,32 patients),the clinical characteristics of the four groups were compared and their correlation with LDL-C was analyzed.Results In non-diabetic patients,LDL-C in the stress-induced hyperglycemia group was significantly higher than in the normoglycemic group[(3.29±1.09)mmol/L vs.(2.92±0.94)mmol/L,P<0.05];LDL-C in the hyperglycemic group was significantly higher than that in the non-stress hyperglycemic group[(2.99±0.85)mmol/L vs.(2.57±0.85)mmol/L,P<0.05].Multivariate logistic regression analysis showed that LDL-C was an independent risk factor for stress-induced hyperglycemia in AMI[OR=1.957,95%CI:1.014~3.774,P<0.05].Conclusions LDL-C is an independent risk factor for AMI stress-induced hyperglycemia.