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目的观察冠心病介入治疗后患者血糖水平对临床疗效以及预后的影响。方法将来咸阳医院就诊的120例冠心病介入治疗患者,按患者血糖水平,将其分为3组:非糖尿病组〔空腹血糖(FPG)<7.0 mmol/L,n=30〕、糖尿病低血糖组(8.0 mmol/L>FPG≥7.0 mmol/L,n=50)和糖尿病高血糖组(FPG≥8.0 mmol/L,n=40)。记录临床资料以及分析生化指标〔血清总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、载脂蛋白水平、三酰甘油(TG)、纤维蛋白原(Fib)以及尿酸(UA)水平〕,并分析急性心肌梗死并发症的发生率。结果糖尿病高血糖组TC、LDL-C、载脂蛋白、左室舒张末内径水平分别为(4.9±1.4)mmol/L、(3.3±0.9)mmol/L、(1.6±0.5)mmol/L和(55±7)mm,显著高于糖尿病低血糖组的(4.1±0.8)mmol/L、(2.7±0.5)mmol/L、(1.1±0.4)mmol/L、(51±8)mm(均P<0.05),糖尿病低血糖组相应指标水平显著高于非糖尿病组的(3.7±1.2)mmol/L、(2.2±0.6)mmol/L、(0.7±0.1)mmol/L和(44±7)mm(均P<0.05)。3组TG、Fib以及UA水平无统计学差异。非糖尿病组患者术后发生急性心肌梗死(AMI)、AMI并发恶性心律失常、AMI并发心衰以及病死率分别为:13%、10%、10%和3%;糖尿病低血糖组为:24%、26%、24%和8%。糖尿病高血糖组为30%、32%、30%和12%。与非糖尿病组比较,糖尿病低血糖组和糖尿病高血糖组相应指标水平均显著升高(均P<0.05),且糖尿病高血糖组指标水平较糖尿病低血糖组高(均P<0.05)。经过非条件Logistic回归分析后,血糖的OR值(95%CI)为4.6(0.8~21.7),P<0.05,结果显示血糖水平是独立的预测因素。结论冠心病患者的血糖水平对于患者的临床疗效和预后有一定影响。
Objective To observe the effect of blood glucose level on the clinical efficacy and prognosis of patients after coronary intervention. Methods A total of 120 patients with CHD treated by Xianyang Hospital in the future were divided into 3 groups according to their blood glucose level: non-diabetic group (fasting blood glucose (FPG) <7.0 mmol / L, n = 30), diabetic hypoglycemia group (8.0 mmol / L> FPG≥7.0 mmol / L, n = 50) and diabetic hyperglycemia group (FPG≥8.0 mmol / L, n = 40). Clinical data were recorded and biochemical parameters (serum total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), apolipoprotein, triglyceride (TG), fibrinogen (Fib) and uric acid 〕, And analyze the incidence of complications of acute myocardial infarction. Results The levels of TC, LDL-C, apolipoprotein and left ventricular end-diastolic diameter in diabetic hyperglycemia group were (4.9 ± 1.4) mmol / L, (3.3 ± 0.9) mmol / L, (1.1 ± 0.4) mmol / L and (51 ± 8) mm respectively in the diabetic hypoglycaemia group (55 ± 7) mm and (0.7 ± 1.2) mmol / L, (2.2 ± 0.6) mmol / L, (0.7 ± 0.1) mmol / L, and (44 ± 7) mmol / L in diabetic hypoglycaemia group ) mm (all P <0.05). Three groups of TG, Fib and UA levels no significant difference. Patients with non-diabetic patients developed acute myocardial infarction (AMI), AMI complicated with malignant arrhythmias, AMI complicated with heart failure and the case fatality rates were 13%, 10%, 10% and 3% respectively; the diabetic hypoglycemia group was 24% , 26%, 24% and 8%. Diabetic hyperglycemia was 30%, 32%, 30% and 12%. Compared with non-diabetic group, the corresponding indexes of diabetic hypoglycemia group and diabetic hyperglycemia group were significantly increased (all P <0.05), and the indicators of diabetic hyperglycemia group were higher than those of diabetic hypoglycemia group (all P <0.05). After unconditional Logistic regression analysis, the OR of blood glucose (95% CI) was 4.6 (0.8-21.7), P <0.05. The results showed that blood glucose level was an independent predictor. Conclusion The blood glucose level of patients with coronary heart disease has certain influence on the clinical efficacy and prognosis of patients.