摘要
目的 对比分析 2型糖尿病患者与非糖尿病患者在急性冠状动脉综合征 (ACS)早期血钾水平的变化。方法 对 1999年 1月至 2 0 0 3年 3月进行急诊冠状动脉介入治疗的连续 745例ACS患者 ,以症状持续时间、2型糖尿病和院前 β 受体阻滞剂使用进行分层。 结果 2型糖尿病ACS患者的血清钾水平较非糖尿病ACS患者明显高〔(4 .3 4± 0 .48)mmol/Lvs (4 .0 0± 0 .5 2 )mmol/L ,P <0 .0 5〕。多变量分析表明 ,2型糖尿病是血清钾水平的独立预测因素 (OR 1.70 ,95 %CI :1.40～ 2 .10 ,P <0 .0 1)。非糖尿病ACS患者在发病 6h内血钾水平随症状持续时间进行性升高〔≤ 2h :(3 .61± 0 .5 1)mmol/L ;2～ 4h :(4 .10± 0 .45 )mmol/L ;4～ 6h :(4 .2 2± 0 .5 1)mmol/L(与≤ 2h比 ,均P <0 .0 1)〕 ,2型糖尿病或院前服用 β 受体阻滞剂治疗患者这种趋势不明显。结论 在ACS早期 ,2型糖尿病患者不出现非糖尿病患者的早期血钾降低 ,反映了 2型糖尿病患者存在交感神经功能障碍。
Objective To compare serum potassium concentrations in type 2 diabetic and nondiabetic patients in the early phase of acute coronary syndromes (ACS). Methods Seven hundred and forty-five consecutive patients with ACS underwent cardiac catheterization from January, 1999 to March, 2003. Patients were stratified by duration of symptoms,type2diabetes,andβ-receptor blocker therapy before admission. Results Serum potassium concentration was significantly higher in type 2 diabetic patients with ACS than that in nondiabetic patients with ACS 〔(4.34±0.48)mmol/L vs (4.00±0.52)mmol/L,P<0.05〕. Multivariate analysis identified type 2 diabetes as an independent predictor of a serum potassium concentration (OR 1.70, 95%CI 1.40-2.10, P<0.01). There was a progressive increase in serum potassium concentrations within 6 h of symptom onset in non-diabetics with ACS 〔(3.61±0.51)mmol/L within 2 h, (4.10±0.45)mmol/L between 2-4 h, (4.22±0.51)mmol/L between 4-6 h, as compared with serum potassium concentration within 2 h, both P<0.01〕. This pattern of increasing serum potassium concentration with duration of symptoms was attenuated in patients with type 2 diabetes and with β-receptor blocker therapy before admission. Conclusion In the early phase of ACS, patients with type 2 diabetes do not exhibit the early dip in serum potassium concentrations as seen in nondiabetics, reflecting that sympathetic nerve dysfunction is a common complication of type 2 diabetes.
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2004年第6期517-519,共3页
Chinese Journal of Endocrinology and Metabolism
基金
北京大学 2 1 1工程循证医学学科群 (930 0 0 2 4 61 560 77)
