高血糖和低血糖与伴急性冠状动脉事件的糖尿病患者2年全因死亡风险的关系
Association between hyper- and hypoglycaemia and 2 year all-cause mortality risk in diabetic patients with acute coronary events作者机构：Clinical Experimental Research Laboratory Sahlgrenska University Hospital/stra 416 85 Gteborg Sweden
出 版 物：《世界核心医学期刊文摘(心脏病学分册)》 (Digest of the World Core Medical Journals(Cardiology))
年 卷 期：2006年第3期
页 面：45-46页
学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学]
摘 要：Aims: The study evaluated the associations between glycometabolic parameters at admission and during hospitatization and 2 year all-cause mortality risk in an unselected cohort of consecutive patients with diabetes admitted for unstable angina or non-Q-wave myocardial infarction to a university hospital during 1988-98. Methods and results: A total of 713 consecutive patients with diabetes were included. During 2 years of follow-up, 242(34% ) patients died. All analyses were retrospective using prospectively collected clinical data. The primary study endpoint was 2 year all-cause mortality collected from the Swedish cause-specific mortality register. In unadjusted analyses, high admission blood glucose(highest vs. lowest quartile: hazard ratio(HR) 2.66; 95% confidence interval(CI) 1.83, 3.86) and hypoglycaemia recorded during hospitalization(hypoglycaemia vs. normal: HR 1.77; 95% CI 1.09, 2.86) were both significantly associated with increased 2 year all-cause mortality risk. These associations remained significant after multivariable adjustment. Conclusion: In the setting of acute coronary syndromes(ACS) among patients with diabetes, hyperglycaemia on arrival and hypoglycaemia during hospitalization are both independently associated with worse adjusted all-cause 2 year mortality risk. These observations suggest that the avoidance of both hyper-and hypoglycaemia during ACS events may be of similar importance, and glucose modulation remains an important objective to address in future randomized trials.
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