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目的研究应激性血糖升高和超敏C反应蛋白检测对急性心肌梗死患者近期预后的影响及意义。方法对2009年9月至2011年7月127例既往无糖尿病病史的急性心肌梗死患者进行分析,记录基本临床资料,检测血糖及超敏C反应蛋白水平,以空腹血糖>7.0 mmol/L划分为有应激性高血糖组(n=65)和<7.0 mmol/L为无应激性高血糖组(n=62)两组,平均随访30 d,比较两组间冠脉病变、心力衰竭、心律失常及院内病死率的发生率。结果伴有应激性血糖增高组的急性心肌梗死患者伴更高的超敏C反应蛋白水平,且多支冠脉病变及非Q波心肌梗死发生率高于血糖正常组(P<0.05),心力衰竭、心律失常及死亡的发生率明显高于血糖正常组(P<0.01)。结论应激性血糖升高及高水平的超敏C反应蛋白是急性心肌梗死患者不良预后的危险因素,有更高的心力衰竭、心律失常及死亡的发生率。
Objective To study the effect and significance of stress hyperglycemia and high sensitivity C-reactive protein detection on the short-term prognosis of patients with acute myocardial infarction. Methods From September 2009 to July 2011, 127 patients with past history of acute myocardial infarction without diabetes mellitus were analyzed and the basic clinical data were recorded. The levels of blood glucose and high-sensitivity C-reactive protein were measured. The fasting glucose> 7.0 mmol / L was divided into There were two groups of stress hyperglycemia (n = 65) and <7.0 mmol / L (n = 62), with a mean follow-up of 30 days. The coronary artery disease, heart failure, Arrhythmia and the incidence of hospital mortality. Results Patients with acute myocardial infarction accompanied by stress hyperglycemia had a higher level of hypersensitive C-reactive protein, and the incidence of multiple coronary artery lesion and non-Q wave myocardial infarction was higher than that of normal blood glucose group (P <0.05) The incidence of heart failure, arrhythmia and death was significantly higher than that of normal blood glucose group (P <0.01). Conclusions Stress-induced hyperglycemia and high-grade Hs-CRP are risk factors for poor prognosis in patients with acute myocardial infarction. They have higher rates of heart failure, arrhythmia and death.