The effect of stress-related hyperglycemia on myocardial function of patients with cardiac disease after non-cardiac surgery
10.3969/j.issn.1008-9691.2015.04.002
- VernacularTitle:非心脏术后应激性高血糖对心脏疾病患者心肌功能的影响
- Author:
Baoyun ZHANG
;
Qingyu ZHAO
;
Xinrong HE
;
Baochun GU
;
Yanxian LI
;
Huan LI
- Publication Type:Journal Article
- Keywords:
Non-cardiac surgery;
Cardiac disorder;
Myocardial function;
Stress-related hyperglycemia;
High-sensitivity cardiac troponin I
- From:
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
2015;(4):342-346
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the effect of stress-related hyperglycemia on myocardial function of patients with cardiac disorder after non-cardiac surgery.Methods The clinical data of 211 patients having undergone thoracic or abdominal operations in Department of Critical Care Medicine of Sun Yat-sen University Cancer Center were retrospectively analyzed. According to the postoperative average blood glucose level in the following 3 days after surgery and the patients' history of cardiac disorder, they were divided into four groups: without hyperglycemia (blood glucose ≤ 10 mmol/L) and cardiac disorder group (HG0CV0 group), without hyperglycemia but with cardiac disorder group (HG0CV1 group), with hyperglycemia (blood glucose > 10 mmol/L) but without cardiac disorder group (HG1CV0 group) and with hyperglycemia and cardiac disorder group (HG1CV1 group). The correlations between the blood glucose and each level of the following items: high-sensitivity cardiac troponin I (hs-cTnI), brain natriuretic peptide (BNP), myocardial zymogram aspartate aminotransferase (AST), creatine kinase (CK), MB isoenzyme of creatine kinase (CK-MB), lactic dehydrogenase (LDH), lactic dehydrogenase isoenzyme (LDH-1), myoglobin (MYO), α- hydroxybutyrate dehydrogenase (HBDH) in each group were analyzed.Results The postoperative blood glucose levels of all 211 patients were significantly higher than those before operation (mmol/L: 8.7±0.2 vs. 5.7±0.2,P < 0.05), and the blood glucose level more than 6.1 mmol/L in postoperative 179 patients accounted for 84.8% of the total. In HG0CV0 group, the postoperative blood glucose level was positively correlated with MYO and AST [r values were 0.193, 0.307; 95% confidence intervals (95%CI) were 0.010 - 0.362, 0.096 - 0.479;P values were 0.038, 0.003]. There were no correlations between postoperative blood glucose level and hs-cTnI, BNP, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05). In HG0CV1 group, the postoperative blood glucose level was negatively correlated with hs-cTnI level (r = -0.609, 95%CI = -0.810 to -0.264,P = 0.001). There were no correlations between postoperative blood glucose level and the levels of BNP, MYO, AST, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05). In HG1CV0 group, there were no correlations between postoperative blood glucoselevel and hs-cTnI, BNP, MYO, AST, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05). In HG1CV1 group, the postoperative blood glucose level was positively correlated with hs-TnI level (r = 0.837, 95%CI = 0.476 - 0.984,P = 0.001). There were no correlations between postoperative blood glucose level and the levels of BNP, MYO, AST, LDH, LDH-1, HBDH, CK and CK-MB (allP > 0.05).Conclusion The early stress-related hyperglycemia after non-cardiac surgery may have a protective effect on myocardial function of patients with cardiac disorder.
