急性心肌梗死患者PCI术后空腹血糖变化规律及影响因素分析

Change Rules and Influencing Factors of Fasting Blood Glucose in Patients with Acute Myocardial Infarction After PCI

目的分析急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后空腹血糖(FPG)变化规律及其影响因素。方法选取2017年11月—2019年2月收治的AMI患者120例为研究对象,均行PCI术,测定术前、术后1 d、术后3 d、术后7 d、术后1个月、术后2个月、术后3个月FPG变化,并依据术后3 d内FPG水平分为偏低组20例、正常组40例、偏高组60例,观察3组FPG变化规律,并分析其影响因素。结果120例AMI患者术后FPG呈先上升后下降趋势(P<0.05),其中术后1、3 d FPG水平较高,在术后3 d达峰值,术后7 d开始下降并维持平稳(P<0.05)。支架置入数量≥2支、支架直径、术前肌酸激酶同工酶(CK-MB)与心肌肌钙蛋白T(cTnT)、术后左心室舒张末期内径(LVDd)为AMI患者PCI术后FPG水平升高的主要影响因素,而左心室射血分数(LVEF)为保护因素(P<0.05,P<0.01)。结论AMI患者PCI术后FPG水平先上升后下降并趋于稳定,支架置入数量与直径、术前CK-MB、cTnT及术后LVDd为导致FPG变化的影响因素,较高的LVEF可能有助于减少FPG波动。

Objective To analyze the change rules of fasting plasma glucose(FPG)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI)and the influencing factors.Methods A total of 120 AMI patients admitted to our hospital from November 2017 to February 2019 were selected as the research subjects,and all of them underwent PCI.FPG changes were measured before operation,at 1,3 and 7 days after operation,and in 1,2 and 3 months after operation.According to the level of FBG within 3 days after operation,the patients were divided into low FPG group(n=20),normal FBG group(n=40)and high FPG group(n=60).The changes of FPG in three groups were observed and the influencing factors were analyzed.Results After surgery,FPG of the 120 AMI patients was increased initially and then decreased(P<0.05).FPG level was relatively higher at 1 and 3 days after surgery,reached the peak at 3 days after surgery,and began to decline and remained stable at 7 days after surgery(P<0.05).The number of stents≥2,stent diameter,preoperative creatine kinase isoenzyme(CK-MB),cardiac troponin T(cTnT)and postoperative left ventricular end diastolic diameter(LVDd)were main influencing factors for increase of FBG levels in AMI patients after PCI,while left ventricular ejection fraction(LVEF)was the protective factor(P<0.05).Conclusion The FPG level of AMI patients after PCI was initially increased,and then decreased and tended to be stable.The number of stent implanted,stent diameter,preoperative CK-MB,cTnT and postoperative LVDd are influencing factors for FPG changes,while higher LVEF may help reduce fluctuations of FPG.