中国住院冠心病患者糖代谢异常研究—中国心脏调查

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1、中国住院冠心病患者糖代谢异常研究—中国心脏调查中国心脏调查组　　【摘要】目的　探讨中国冠心病患者糖代谢异常的流行状况。方法　选取北京、上海等7个城市共52家三级甲等医院为合作研究中心，于2005年6月1日至2005年9月30日在各医院心内科所有符合冠心病诊断纳入标准的住院患者连续入选为研究对象，共收集有效病例3513例。未确诊为糖尿病的对象均需进行口服葡萄糖耐量试验(OGTT)，以判断糖代谢状况。结果　冠心病住院患者中糖尿病患病率为52.9%，糖调节受损患病率为24.0%，总的糖代谢异常患病率为76.9%。若不进行OGTT试验，仅依靠检测空腹血糖，将有87.4%糖调节异常患者和80.

2、5%糖尿病患者被漏诊。结论　中国冠心病住院患者中绝大多数合并糖代谢异常，并且需要通过OGTT及时准确地发现这些合并糖代谢异常的患者。【关键词】冠状动脉疾病;糖尿病;糖尿病前期;葡糖耐量试验;患病率Cross-sectionalstudyontheprevalenceofabnormalglucosemetabolisminpatientswithcoronaryarterydiseaseinChina——ChinaHeartSurvery　ChinaHeartSurveryGroupCorrespondingauthors:HUDa-yi,CenterforHeart,Lungand

3、BloodVessel,TongjiUniversity,Shanghai200092;PANChang-Yu,DepartmentofEndocrinology,ChinesePLAGeneralHospital,Beijing100853　　【Abstract】Objective　Toinvestigatetheglucometabolicprofileofpatientswithcoronaryarterydisease(CAD)inChina.MethodsFiftytwohospitalsin7citiesinChinapaticipatedinthesurvey.Alli

4、npatientswithCADincardiologydepartmentofeachhospitalwereconsecutivelyrecruitedfromJun1,2005toSep30,2005.Atotalof3513patientswithCADwereincludedinthestudy.Patientswithpreviouslyknowndiabetesmellitus(DM)(1153patients)andnewlydiagnosedDM(97patients)werenotaskedtoperformoralglucosetolerancetest(OGT

5、T).TheotherswouldperformOGTTtocharacterizetheglucosemetabolismstatus.ResultsTheprevalencesofpatientswithDMandimpairedglucoseregulationwere52.9%and24.0%ininpatientwithCAD,respectively.Thetotalprevalenceofabnormalglucosemetabolismwas76.9%.WithouttheuseofOGTT,amajorityofpatientswithabnormalglucose

6、metabolismwouldhaveremainedundiagnosedintheenergencyadmissiongroup(437outof517,84.5%)andthescheduledadmissiongroups(791outof936,84.5%)respectively.Intotal,87.4%(738/844)impairedglucoseregulationand80.5%(490/609)DMwouldremainundiagnosedbyfastingplasmaglucose(FPG)detectionalone.ConclusionThefrequ

7、encyofdisturbedglucosemetabolismisconsiderablyhighininpatientswithCAD.TheprevalenceofabnormalglucosemetabolismwouldbeobviouslyunderestimatedbymeasuringFPGonly.OGTTeasilydisclosestheglucometabolicstatusandshouldbeasaroutineprocedur