CAJ | 학술논문

目的：探讨急性冠脉综合征患者血糖变异性与冠脉病变程度的相关性。方法回顾性分析2012年4月~2013年12月我院收治的160例ACS患者的临床资料，将所有患者按照是否合并糖尿病分为A组80例，该组均为ACS合并糖尿病患者；B组80例，该组均为ACS不合并糖尿病患者。比较两组患者基本临床特征、冠脉狭窄分数、血糖变异系数及住院期间不良事件发生率，并用多元逐步回归分析预后的影响因素。结果 A组患者的TC、HDL-C水平与B组的比较明显降低，而纤维蛋白原水平及高血压患者比例与B组的相比则较高，差异有统计学意义（P＜0.05）；A组患者冠脉狭窄分数、血糖变异系数及严重心律失常、心衰、心源性休克及死亡发生率与B组的比较均明显升高，差异有统计学意义（P＜0.05）。糖尿病、HDL-C、血糖变异系数、高血压病程及平均血糖水平均为死亡率的影响因素（P＜0.05）。结论 ACS患者住院期间的血糖变异性会影响其近期预后，临床医生应对ACS患者血糖加强监测力度，保持血糖平稳，使ACS患者的预后改善。
목적：탐토급성관맥종합정환자혈당변이성여관맥병변정도적상관성。방법회고성분석2012년4월~2013년12월아원수치적160례ACS환자적림상자료，장소유환자안조시부합병당뇨병분위A조80례，해조균위ACS합병당뇨병환자；B조80례，해조균위ACS불합병당뇨병환자。비교량조환자기본림상특정、관맥협착분수、혈당변이계수급주원기간불량사건발생솔，병용다원축보회귀분석예후적영향인소。결과 A조환자적TC、HDL-C수평여B조적비교명현강저，이섬유단백원수평급고혈압환자비례여B조적상비칙교고，차이유통계학의의（P＜0.05）；A조환자관맥협착분수、혈당변이계수급엄중심률실상、심쇠、심원성휴극급사망발생솔여B조적비교균명현승고，차이유통계학의의（P＜0.05）。당뇨병、HDL-C、혈당변이계수、고혈압병정급평균혈당수평균위사망솔적영향인소（P＜0.05）。결론 ACS환자주원기간적혈당변이성회영향기근기예후，림상의생응대ACS환자혈당가강감측력도，보지혈당평은，사ACS환자적예후개선。
Objective To explore the correlation between blood glucose variability and coronary artery lesions on the patients with acute coronary syndrome (ACS). Methods Clinical data of 160 cases with ACS selected from Apr 2012 to Dec 2013 were retrospectively analyzed, 80 ACS patients combined with diabetes were distributed into group A, the other ACS pa-tients without diabetes were distributed into group B. The basic clinical characteristics, coronary stenosis score coefficient, vari-ation of blood glucose and hospitalization incidence of adverse events between the two groups were compared , and analyzed the prognostic factors with multiple regression. Results TC, HDL-C levels of group A was significantly lower than group B, fib-rinogen level and the proportion of patients with hypertension was higher than group B , the difference was statistically signifi-cant (P<0.05); coronary stenosis scores coefficient, variation of blood glucose and the incidence of severe arrhythmia, heart failure, cardiogenic shock and death rate was significantly higher than group B, the difference was statistically significant (P<0.05). Diabetes, HDL-C, glucose coefficient of variation, the average duration of hypertension and average blood glucose levels were all the influence factors of mortality (P<0.05). Conclusion Blood glucose variability of the patients with ACS during hospitalization can affect its short-term prognosis. Clinicians should strengthen to keep blood glucose stable to improve the prog-nosis of patients with ACS.