强化血糖控制对改善冠脉支架植入患者临床预后的作用

Improving effect of intensive blood glucose control on clinical prognosis in patients undergoing coronary stent implantation

目的:分析强化血糖控制对行冠脉支架植入(PCI)患者的作用。方法:2017年1月至8月我科120例PCI患者被随机均分为常规治疗组(根据血糖水平适当调节胰岛素泵入量)和强化血糖控制组(每餐前增加2~4U/h胰岛素泵入量,持续至餐后2h,其余同常规治疗组)。观察比较两组术后血糖达标时间、胰岛素用量、并发症以及再狭窄情况。结果:与常规治疗组比较,强化血糖控制组术后血糖达标时间[(3.58±0.27)d比(2.31±0.15)d]、胰岛素用量[(101.54±13.65)U比(96.41±12.82)U]、并发症总发生率(15.00%比3.33%)和再狭窄率(15.52%比3.57%)均显著降低,P<0.05或<0.01。结论:为冠脉支架植入患者行强化血糖控制,可促使血糖更快达标,减少胰岛素用量,降低术后并发症和再狭窄风险,应用前景广阔。

Objective:To analyze effect of intensive blood glucose control on patients undergoing coronary stent implantation(PCI).Methods:A total of 120 PCI patients,who were hospitalized in our department from Jan 2017 to Aug 2017,were randomly and equally divided into routine treatment group(regulated pump-in dose of insulin according to blood glucose level)and intensive blood glucose control group(rose pump-in dose of insulin by 2~4U/h before each dinner and maintained for 2h after dinner,and other treatment were same as those of routine treatment).Blood glucose standard-reaching time and insulin dose after PCI,incidence of complications and restenosis were observed and compared between two groups.Results:Compared with routine treatment group after PCI,there were significant reductions in blood glucose standard-reaching time[(3.58±0.27)d vs.(2.31±0.15)d],insulin dose[(101.54±13.65)U vs.(96.41±12.82)U],total incidence rate of complications(15.00%vs.3.33%)and restenosis rate(15.52%vs.3.57%)in intensive blood glucose control group,P<0.05 or<0.01.Conclusion:Intensive blood glucose control can make blood glucose reach standard sooner,reduce insulin dose,risk of postoperative complications and restenosis in patients undergoing coronary stent implantation,which possesses a broad application prospect.