Correlation Analysis Between Stess Hyperglycaemia And Microalbuminuria Of Acute Coronary Syndrome

Objective: acute coronary syndrome (ACS), the most common manifestation of ischemia cardiomyopathy, refers to severe myocardial ischemia case caused by coronary atherosclerotic plaque rupture or coronary artery hemorrhage suppository, including unstable angina pectoris, acute non-ST-segment elevation myocardial infarction and acute ST-segment elevation myocardial infarction. Many researches on epidemiology and large-scale clinical experiments confirm that diversification of structure and function of blood vessel is closely related to occurrence and prognosis of cardiovascular and cerebrovascular diseases, thus active recognition and control to risks of cardiovascular diseases has important clinical value to delay or interdiction disease process. It has been confirmed till now that stress-induced hyperglycemia--a predictor of cardiovascular events--can not only intensify body inflammatory response, but also lead to oxidative stress, which may lead to vascular endothelial dysfunction and play an important role in the occurrence and development process of atherosclerosis and is moreover one of pathophysiologic mechanisms of occurrence of diabetic macroangiopathy. Oxidative stress is mainly expressed by oxidation-induced vascular gene to facilitate local inflammatory response and cell proliferation and extensively involve in occurrence and development of atherosclerosis.Domestic and overseas researches have demonstrated that sensitivity indexes of microalbuminuria (MAU) renovascular and microvasculature diseases are not only the early symptom of global vascular diseases and renal damage such as high blood pressure and diabetes, but also risks of independent occurrence of cardiovascular events.This experiment probes into the influence of oxidation stress on coronary artery diseases through study on oxidation stress of pertinence of patients with acute coronary syndrome merging stress hyperglycemia and MAU, test in advance and prevent occurrence of these diseases and development of diseases.Methods: to select 134 acute coronary syndrome patients from Hebei Medical University the second Affiliated Hospital in Dec. 2007—Oct. 2008, 75 male and 59 female respectively; age 63.19±9.62; divided into acute coronary syndrome group and acute coronary syndrome merging stress hyperglycemia (the former one is classified to be Group non-SH(64), while the later one is classified to be Group SH (70)). All patients meet the corresponding selected standard and according the measurement of hospital, glycosylate hemoglobin is tested lower than 6.0% and fasting glucose level has also been tested. All patients are classified into blood sugar<7.0 mmol/L and blood sugar≥7.0 mmol/L and compared.To collect 24-hour urine from objects, measure the total urine output and take samples according to standard; to use BeckmanArray360 fully automated scattering turbidimeter and matching urine MAU immunity turbidness measurement reagent and adopt turbidimetric immunoassay and measure it according to standard steps. It is determined to be positive microalbuminuria if MAU is in 20~200mg/24h or urinary albumin excretion (UERA) is in 20~200μg/min.Statistical analysis: the data gained is expressed by mean±standard deviation( x_±s). Statistical analysis software SPSS13.0 is used to conduct statistical analysis and t examination is used to compare between two groups. Followed by homogeneity of variance examination among multi-groups, analysis of variance is performed and rank-sum test is performed if variance is not homogeneous. At last, to know whether each parameter is linear with MAU and perform Spearman correlative analysis.ⅹ2 examination is used to compare multi-group sample rate and Logistic stepwise regression is used to analyze relation between blood sugar and MAU (if P<0.05, it is significant disparity).Result: Parameters in Group non-SH and Group SH: there is not obvious disparity in gender, age or blood pressure (P>0.05) between the two groups, but MAU level is much higher and significant increase in Group SH(P<0.05); correlation analysis of Group SH shows blood sugar and MAU are closely correlative, r=0. 824,P<0.01. Let MAU be induced variable and each parameter be independent variable, to perform multi-factor Logistic stepwise regression analysis, from which it can be found blood sugar is the independent risk factor of MAU, OR=1.024,P<0.001.Conclusion: MAU level of acute coronary syndrome merging stress hyperglycemia patients is obvious ascent and to be positive correlation of GLU level,consequently hyperglycemia is obviously correlative to early damage of acute coronary syndrome; Multi-factor Logistic stepwise regression shows that MAU is the independent risk factor of early damage of acute coronary syndrome patients.