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目的:观察非ST段抬高心肌梗死(NSTEMI)患者发病初期血糖的变化,以了解此类患者血糖的变化规律。方法:对2010年3月~2011年6月在我院住院的既往无糖尿病史并发NSTEMI的86例患者作为研究对象。入院即刻及入院后第2~7天清晨6点采集患者空腹血液,进行空腹血糖浓度测定,并在第7天行OGTT。结果:86例患者中,新诊断为糖尿病者28人,糖调节受损者39人,糖代谢正常者19人。糖代谢正常者平均血糖在入院后第2天降至正常水平。空腹高血糖与OGTT阳性一致性检验Kappa=0.260,P=0.014,在校正其它变量的情况下,第2天空腹血糖≥7.0mmol/L都是糖尿病(OGTT阳性)的预测因素(风险比=3.55,95%可信区间2.114~11.126,P=0.012。结论:既往无糖尿病史的NSTEMI患者大多合并有糖调节受损或糖尿病(67人,77.9%),需及时进行OGTT,以明确糖尿病或糖调节受损。糖代谢正常者一般血糖在入院后第2天降至正常水平。持续高血糖是糖调节受损或糖尿病的预测因子。
Objective: To observe the changes of blood glucose during the early stage of non-ST-segment elevation myocardial infarction (NSTEMI) to understand the changes of blood glucose in these patients. Methods: From March 2010 to June 2011 in our hospital in our hospital with no previous history of diabetes NSTEMI in 86 patients as the research object. Fasting blood was collected immediately after admission and at 6:00 am on the 2nd to 7th days after admission, and fasting blood glucose levels were measured. OGTT was performed on the 7th day. Results: Of the 86 patients, 28 were newly diagnosed with diabetes, 39 were impaired glucose regulation, and 19 were normal glucose metabolism. Average glucose metabolism normal average blood glucose fell to normal after 2 days of admission. Fasting hyperglycemia and OGTT positive consistency test Kappa = 0.260, P = 0.014, fasting blood glucose ≥ 7.0 mmol / L on day 2 was a predictor of diabetes (OGTT positive) in adjusted other variables (hazard ratio = 3.55 , 95% confidence interval 2.114 ~ 11.126, P = 0.012. Conclusion: NSTEMI patients with no previous history of diabetes mellitus often have impaired glucose regulation or diabetes (67, 77.9%). OGTT should be performed in time to determine whether diabetes or sugar Impaired regulation Glycometabolism General glucose levels are generally reduced to normal levels by day 2 post-hospitalization Persistent hyperglycemia is a predictor of impaired glucose regulation or diabetes.