血糖控制对急性心肌梗死患者C反应蛋白及近期预后的影响

摘要

目的 探讨伴2型糖尿病的急性心肌梗死患者血糖控制情况对高敏C反应蛋白(hs-CRP)水平及住院期间不良心血管事件产生的影响.方法 110例急性心肌梗死患者分为3组,Ⅰ组为不伴糖尿病组,Ⅱ组为伴2型糖尿病且血糖控制良好组,Ⅲ组为伴2型糖尿病且血糖控制不良组.观察3组患者既往糖化血红蛋白水平、入院后hs-CRP水平及不良心血管事件发生.结果 Ⅱ组和Ⅲ组患者hs-CRP水平分别为(7.21±1.37)mg/L、(9.48±1.10)mg/L,明显高于Ⅰ组(3.56±1.72)mg/L,差异有统计学意义(均P<0.01).Ⅰ组、Ⅱ组和Ⅲ组不良心血管事件发生概率分别为13.5%(7/52)、31.6%(12/38)和60.0%(12/20),Ⅱ组与Ⅰ组比较P<0.05,Ⅲ组与Ⅰ组比较P<0.01.结论 血糖控制不良可抬高伴2型糖尿病的心肌梗死患者hs-CRP水平,伴2型糖尿病的冠心病患者控制血糖可改善发生心肌梗死后的近期预后.%Objectives To study the influence of blood glucose control on high sensitive C reactive protein (hs-CRP) and serious cardiovascular events in acute myocardial infarction patients in hospital. Methods The level of former HbAlc, hs-CRP and serious cardiovascular events were observed in one hundred and ten acute myocardial infarction patients with or without type 2 diabetes. Results The acute moycardial infarction patients with type 2 di-abetes showed a higher level of hs-CRP than these patient without type 2 diabetes(P <0.01). These patients with type 2 diabetes with a bad blood glucose control had a higher level of hs-CRP than these with a good glucose control.The acute moycardial infarction patients with type 2 diabetes also showed a high probability of serious cardiovascular events(with a good glucose control group, P < 0.05; with a bad glucose control group, P < 0.01). The patients with type 2 diabetes with a bad blood glucose control has a higher probability of serious cardiovascular events than these with a good glucose control(P<0.05). Conclusions A bad blood glucose control can increase the level of hs-CRP in acute myocardial infarction patients with type 2 diabetes, but a good glucose control can improve short-term prognosis of coronary heart disease patients with type 2 diabetes after acute myocardial infarction.