陈旧性心肌梗死血葡萄糖、胰岛素分泌变化的临床意义
Clinical significance of the level of blood glucose and insulin in old myocardial infarction
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摘要: 目的: 探讨冠心病心肌梗死患者血糖、胰岛素分泌变化。方法: 来自住院的52例心肌梗死患者和71例对照,进行葡萄糖糖耐量试验和胰岛素释放试验,运用稳态模式法评价胰岛素敏感性与心肌梗死的关系。结果: 心肌梗死组糖尿病患病率(46.2%)明显增多(P<0.01),胰岛素敏感指数HOMAIS(237.19±162.35比415.52±272.64)明显降低(P<0.05)。服糖后60min血糖(12.55±4.58)mmol/L,120min血糖(12.18±5.50)mmol/L,180min血糖(9.13±4.65)mmol/L水平升高有统计学意义(P<0.01)。同时,空腹胰岛素(14.85±10.60)mU/L,服糖后30min胰岛素(54.32±42.33)mU/L,60min胰岛素(76.36±49.30)mU/L分泌减低有统计学意义(P<0.05)。结论: 陈旧性心肌梗死患者存在血糖、胰岛素分泌异常。Abstract: Objective: To investigate the changes of blood glucose and insulin after myocardial infarction. Methods: Oral glucose tolerance test （OGTT） and insulin release test was used to measure concentration of blood glucose and insulin before and after oral 75g glucose in 0h, 0.5h, 1h, 2h and 3h, were recorded in 52 subjects with old myocardial infarction（OMI） and 71 controls. HOMA IR and HOMA IS were calculated by Homeostasis model assessment（the Homa model）. Results: It was a high morbidity of diabetes （46.2%, P＜0.01） and lower insulin sensitivity （237.19162.35 vs 415.52272.64, P＜0.01） in old myocardial infarction. Significant glycaemia in 60min,120min,180min with post-glucose load in persons with OMI than controls, P＜0.01. The level og insulin in fasting,30 and 60min with post-glucose load secrete lower than conurols, P＜0.05. （Conclusion: ）There are abnormal levels of blood glucose and insulin with old myocardial infarction.
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