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Short-term prognosis evaluation of plasma brain natriuretic peptide concentration on the non-diabetic acute myocardial infarction patients with stress hyperglycemia
Author(s): 
Pages: 128-131
Year: Issue:  2
Journal: Journal of Clinical Cardiology

Keyword:  急性心肌梗死 脑钠肽 应激性高血糖 预后;
Abstract: 目的:观察非糖尿病急性心肌梗死(AMI)并发应激性高血糖患者血浆脑钠肽(BNP)水平变化,探讨血浆BNP在非糖尿病AMI并发应激性高血糖患者近期预后评估中的作用。方法:将60例AMI患者根据空腹血糖值分为2组,非糖尿病AMI并发应激性高血糖组(试验组)(血糖≥7.0mmol/L)36例,AMI未并发应激性高血糖组(对照组)(血糖<7.0mmol/L)24例,对AMI患者在发病后24h时测定血浆BNP水平。所有入选患者入院后2周行心脏彩超检查,测定和计算左室舒张末期内径(LVDd)、左室收缩末期内径(LVSd)、左室射血分数(LVEF);同时行24h动态心电图检测,记录2组患者心律失常发生率;并观察住院2周内心绞痛、心力衰竭、心源性休克、心源性猝死等主要不良心血管事件(MACE)发生率。结果:①发病后24h血浆BNP浓度试验组明显高于对照组[(671.87±631.71)ng/L∶(299.53±455.67)ng/L,P<0.01]。②试验组LVDd、LVSd均高于对照组[(53.01±4.00)mm∶(50.50±3.20)mm,(45.32±5.92)mm∶(42.52±3.27)mm,均P<0.05],LVEF低于对照组[(52.86±5.79)%∶(61.00±7.54)%,P<0.05]。③试验组室性心律失常、室上性心律失常、严重窦性心动过缓和房室传导阻滞发生率均高于对照组(分别为66.67%∶41.67%,63.89%∶37.50%,47.22%∶20.83%,均P<0.05)。④试验组与对照组住院2周内MACE发生率,包括心力衰竭(36.11%∶12.50%)、心源性休克(16.67%∶0.00%)、梗死后心绞痛(25.00%∶4.17%)均差异有统计学意义(均P<0.05);死亡率(2.78%∶0.00%)差异无统计学意义(P>0.05)。结论:非糖尿病AMI并发应激性高血糖患者近期预后差,血浆BNP水平升高更为明显。
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