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目的:分析急性冠状动脉综合征(ACS)患者合并糖耐量异常对D-二聚体(DD)含量的影响。方法:选择135例住院治疗的ACS患者。根据糖代谢情况,患者被分为单纯ACS组(48例),2型糖尿病(T2DM)+ACS组(46例)和糖耐量减低(IGT)+ACS组(41例);同期住院健康体检者35例作为正常对照组。测定比较各组的血浆DD水平。结果:与正常对照组和单纯ACS组比较,T2DM+ACS组和IGT+ACS组的甘油三酯水平[(1.12±0.39)mmol/L,(1.52±0.92)mmol/L比(2.57±1.17)mmol/L,(2.32±0.96)mmol/L]显著升高(P均<0.01);与正常对照组比较,单纯ACS组、T2DM+ACS组和IGT+ACS组患者血浆DD水平[(360.50±74.95)ng/ml比(795.24±134.10)ng/ml比(663.31±116.06)ng/ml,(702.40±126.64)ng/ml]均显著升高(P均<0.01);而T2DM+ACS组和IGT+ACS组的血浆DD水平显著低于单纯ACS组(P均<0.05)。结论:急性冠状动脉综合征合并糖耐量减低患者纤溶系统功能较单纯ACS患者减退。
Objective: To analyze the effect of combined glucose tolerance (IGT) on D-dimer (DD) in patients with acute coronary syndrome (ACS). Methods: 135 hospitalized patients with ACS were selected. According to the status of glucose metabolism, the patients were divided into ACS group (48 cases), T2DM group (46 cases) and IGT group (41 cases). In the same period, 35 cases as normal control group. Determination of plasma DD levels in each group were compared. Results: The levels of triglyceride in T2DM + ACS group and IGT + ACS group were (1.12 ± 0.39) mmol / L and (1.52 ± 0.92) mmol / L, respectively, compared with those in normal control group and simple ACS group (2.57 ± 1.17) (P <0.01). Compared with the normal control group, plasma DD level in ACS group, T2DM + ACS group and IGT + ACS group [(360.50 ± (74.95) ng / ml (795.24 ± 134.10) ng / ml (663.31 ± 116.06 ng / ml, (702.40 ± 126.64) ng / ml] The level of plasma DD in IGT + ACS group was significantly lower than that in ACS group (all P <0.05). CONCLUSION: Fibrinolytic system in patients with acute coronary syndrome complicated with impaired glucose tolerance declines more than patients with ACS alone.