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非ST段抬高心肌梗死病人糖耐量的动态变化 |
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本文着重观察NSTEMI病人急性住院时及3个月后的糖耐量的异常患病率。[4～8]
本文发现，在NSTEMI病人中，AGT的患病率在急性住院时高达61.2%，比3月随访结束时40.8%，有明显差异，P<0.05，1/3的病人糖耐量较入院时得到改善，2hOGTT血糖值也明显降低。但空腹血糖无明显变化，可能解释是急性入院时由ACS导致的应激性高血糖，住院后经治疗处理，病情改善所致。但D.Y.Hu等人认为：1)从入院到实施OGTT的时间间隔和OGTT血糖水平之间并无关联;2)心肌坏死面积(由肌钙蛋白T的水平来表示)与空腹血糖水平(r=0.10,P=0.48)及2hOGTT血糖(r=-0.07,P=0.58)无关联。[9]本文既往无糖尿病史的NSTEMI病人中AGT患者，大部分为IGT，后者不能由空腹血糖测定来检出，唯一可靠方法是OGTT。总之，本文NSTEMI病人的糖耐量在发病3个月后有所改善，但原因尚不清楚。今后应进一步扩大样本量，增加检测次数和延长观察时间以评估患者动态血糖改变，及评估AGT对心脏疾病预后意义。
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