本文選題：心肌梗死 + 高血糖癥��； 參考：《中國循環(huán)雜志》2017年05期

【摘要】：目的:探討在圍手術(shù)期應(yīng)用胰高血糖素樣肽(GLP)-1與胰島素對ST段抬高型心肌梗死(STEMI)合并應(yīng)激性高血糖患者進(jìn)行干預(yù),比較兩種干預(yù)方法對患者心肌灌注及預(yù)后的影響。方法:本研究為前瞻性、單中心、隨機(jī)對照研究,連續(xù)入選首次發(fā)生STEMI并于12 h內(nèi)接受急診經(jīng)皮冠狀動脈介入治療且入院即刻血糖≥11.1 mmol/L的非糖尿病患者114例,利用隨機(jī)數(shù)字表分為觀察組(GLP-1干預(yù),59例)和對照組(胰島素干預(yù),55例)。對比兩組術(shù)后心肌灌注、心肌損傷指標(biāo)、心功能指標(biāo)及心肌梗死面積(MIA)、心肌挽救指數(shù)(MSI),隨訪6個月,記錄兩組心血管不良事件(MACE)情況。結(jié)果:觀察組圍手術(shù)期肌酸激酶同工酶及心肌肌鈣蛋白T的峰值較對照組降低(P0.05);術(shù)后6個月,觀察組心肌灌注、左心室射血分?jǐn)?shù)均高于對照組(P0.05),同時觀察組較對照組患者M(jìn)IA減少[(15±12)g vs(20±14)g,P0.05],MSI增加12%(0.64±0.13 vs 0.56±0.12,P0.001),但MACE發(fā)生差異無統(tǒng)計學(xué)意義(P=0.217)。結(jié)論:STEMI患者合并應(yīng)激性高血糖,圍手術(shù)期應(yīng)用GLP-1可以在安全調(diào)節(jié)血糖的同時,逐步改善心肌灌注及心臟功能,減少MIA,但未發(fā)現(xiàn)其對圍手術(shù)期的心肌灌注及6個月MACE發(fā)生產(chǎn)生影響。
[Abstract]:Objective: to investigate the effect of glucagon like peptide GLP-1 and insulin on STEMI-induced stress hyperglycemia in patients with ST-segment elevation myocardial infarction (STEMI) during perioperative period, and to compare the effects of two intervention methods on myocardial perfusion and prognosis. Methods: a prospective, single-center, randomized controlled trial was conducted in 114 patients with non-diabetic patients who had STEMI for the first time and received emergency percutaneous coronary intervention (PCI) within 12 hours with blood glucose 鈮，

本文編號：1850702