甘油三酯增高的冠心病患者行糖耐量试验的临床观察

Observation of Oral Glucose Tolerance Test on Patients with Coronary Heart Disease Accompanied by High Triglyceride

目的对甘油三酯增高的冠心病患者进行糖耐量试验,了解糖代谢紊乱的发生情况。方法 162例冠心病患者,年龄(77±7)岁,均为男性。空腹抽血查血糖、甘油三酯、高密度脂蛋白,然后行口服葡萄糖耐量试验(OGTT),了解糖代谢紊乱情况。按照甘油三酯<1.7mmol/L、1,7-2.0mmol/L和≥2.0mmo1/L分为ABC三组,比较三组患者糖耐量试验的差异。结果 162例中,糖尿病43.2%,糖耐量异常24.7%,糖调节受损7.4%,空腹血糖受损4.9%,正常血糖21.6%,共有78.3%存在糖代谢异常。如果单纯检测空腹血糖,将有41,4%漏诊糖尿病,24.7%漏诊糖调节紊乱。B组及C组空腹血糖与A组比较有显著差异(P<0.01和P<0.05)。C组餐后2 h血糖与A组比较也有显著性差异(P<0.05)。结论冠心病患者可能有较高比例的糖代谢紊乱,有必要常规进行OGTT试验,尤其是伴有甘油三酯增高的患者,从而早期发现糖尿病或糖代谢紊乱,避免漏诊。

Objective Oral glucose tolerance test(OGTT) was performed in patients with coronary heart disease(CHD) accompanied with high level of triglyceride<TG) in order to understand the occurrence of abnormal glucose metabolism.Methods 162 male patients with CHD.aged 64-90 years old,were selected and fasting blood were got to detect fasting plasma glucose(FPG).TG and high density lipoprotein(HDL).Then 7Sg glucose were taken orally and 2 hours later,blood were again got to detect plasma glucose.Meanwhile three groups were divided according to the level of triglyceride,in group A the level of TG was less than 1.7 mmol/L.in group B the TG was equal or greater than 1.7 mmol/L and less than 2.0 mmol/L,and in group C the level of TG was equal or greater than 2.0 mmol/L and difference among groups were compared.Results Among 162 patients,43.2%were diagnosed diabetes mellitus(DM),7.4%were IGR,4.9%were IFG and 21.6%were NGT,there were totally 78.3%suffered abnormal glucose metabolism,and if only FPG was measured there may be 41.4%of DM and 24.1%of disturbed glucose regulation missed diagnosis.Meanwhile the comparison of FBG of group B and C to group A showed significantly difference(P<0.01 and P<0.05 respectively),and difference of 2hPG between group C and group A was also significant(P<0.05).Conclusion The results showed that there may be more occurrence of abnormal glucose metabolism in patients with GHD so it is necessary for them to perform OGTT to find abnormal glucose metabolism earlier,especially in those with high level of TG,avoiding missed diagnosis of abnormal glucose metabolism.