应激性高血糖与急性心肌梗死心肌缺血再灌注损伤关系的
研究
李韶南;李广镰;雷晓明;刘震;冯开薇;刘戬;吕磊
【期刊名称】《中国实用内科杂志》 【年(卷),期】2009(029)012
【摘要】Objective To investigate the relationship between stress-induced hyperglycemia (SHG) and myocardial ische-mia-reperfusion injury(MIRI) in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coro-nary intervention (PCI). Methods The study included 156 patients with AMI undergoing primary PCI, all of whom have no diabetes through oral glucose tolerance test( OGTT). The patients were diveded into three group according to the level of fasting blood glucose(FBS) examined within 24 h since AMI onset:control group( FBS <6. 1 mmol/L) ,general stress group(6. 1 mmol/L≤S FBS≤ 11. 1 mmol/L) and great stress group (FBS > 11. 1 mmol/L) .comparing the indicators inclu-ding incidence rate of MIRI,peak value of CK-MB,peak time of CK-MB,Correct TIMI frame count(CTFC) ,STR;The in-cidence rate of MACE during 30 d postoperation in three group. Results The incidence rate of MIRI ,the peak value and peak time of CK-MB,the myocadial reperfusion levels in control group were better than those in SHG group,while these indicators in general stress group were better than those in great stress
group. And the incidence rate of MACE during 30 days postoperation in SHG group was higher than that in control group. Multiple factor Logistic regression analysis indica-ted that SHG was one of the independent predictive factors for MIRI during primary PCI. Conclusion SHG is associated with MIRI in patients with AMI undergoing primary PCI. The emergence and the severity of SHG enhance MIRI and affect the recent prognosis of AMI patients undergoing primary PCI.%目的 探讨应激性高血糖(SHG)与急性心肌梗死(AMI)患者直接经皮冠状动脉腔内介入治疗(PCI)时心肌缺血再灌注损伤(MIRI)发生的关系及对患者近期预后的影响.方法 选择2007年6月至2008年10月广州市第一人民医院心内科院心内科接受直接PCI治疗的急性sT段抬高型AMI患者156例,均为非糖尿病患者.按AMI起病后24 h内空腹血糖(FBS)浓度分为对照组(FBS<6.1 mmol/L)与SHG组(FBSI≥6.1 mmol/L),SHG组患者又分为一般应激组(FBS≤11.1 mmol/L)和严重应激组(FBS>11.1 mmol/L).比较3组患者直接PCI术中MIRI的发生率,肌酸激酶同工酶(CK-MB)峰值、峰值时间,术后心肌灌注水平指标校正TIMI帧计数(CTFC)、术后2 h ST段回落(STR)及术后30 d内主要不良心脏事件(MACE)的发生率.结果 对照组患者与SHG组患者在一般临床基线情况及冠状动脉造影资料方面差异无统计学意义(P>0.05),但在MIRI发生率、CK.MB峰值、峰值时间及CTFC、STR等指标方面对照组均优于SHG组,一般应激组又优于严重应激组,差异有统计学意义(P均<0.05),直接PCI术后30 d内MACE的发生率SHG组显著高于对照组(19.39%与6.90%,P<0.05).多因素Logistic回归分析显示SHG是直接PCI术中MIRI发生的独立预测因子(P<0.05).结论 SHG与AMI患
者直接PCI治疗时MIRI的发生及严重程度存在相关性,SHG加剧MIRI可能是影响AMI患者直接PCI术后近期预后的重要因素. 【总页数】4页(1126-1129)
【关键词】心肌梗死;血管成形术;经腔;经皮冠状动脉;应激性高血糖 【作者】李韶南;李广镰;雷晓明;刘震;冯开薇;刘戬;吕磊
【作者单位】广州市第一人民医院心内科,广州,510180;广州市第一人民医院心内科,广州,510180;广州市第一人民医院心内科,广州,510180;广州市第一人民医院心内科,广州,510180;广州市第一人民医院心内科,广州,510180;广州市第一人民医院心内科,广州,510180;广州市第一人民医院心内科,广州,510180 【正文语种】中文 【中图分类】R5 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_chinese-journal-practical-internal-medicine_thesis/0201231875018.html 【相关文献】
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应激性高血糖与急性心肌梗死心肌缺血再灌注损伤关系的研究
