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糖尿病对冠状动脉介入治疗后心肌灌注的影响 被引量:2

Impact of Diabetes Mellitus on Myocardial Microcirculation Reperfusion of Acute Myocardial Infarction Patients After Percutaneous Coronary Intervention
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摘要 目的探讨糖尿病合并急性心肌梗死(AMI)患者 ,冠状动脉介入治疗(PCI)后心肌微循环灌注状态。方法PCI再灌注成功的AMI患者85例,根据有无合并糖尿病分为两组 ,以反映心肌微循环灌注状态的简易实用指标 :心电图的ST段回落速度为标准 ,计算再灌注治疗90min后12导联心电图ST段的下移幅度,并进行比较。结果糖尿病组患者PCI后ST段的下移幅度<70 %的明显高于非糖尿病组(60 %vs39 % ,P<0.05) ,TIMI血流3级少见 (81%比96% ,P<0.05) ,左心室射血分数明显低于非糖尿病组(47 %vs56 %,P<0.05),左心功能不全、室性心律失常发生率均明显高于非糖尿病组(10%vs4.6 %;32%vs15 %,P<0.05))。结论AMI再灌注治疗后,心肌组织水平灌注状态与临床预后有关。 Objective To investigate myocardial microcirculation reperfusion after percutaneous coronary inˉtervention(PCI)of diabetes mellitus(DM)on it.Methods85cases of acute myocardial infarction(AMI)patients who underwent successful PCI were divided into2groups:patients with type2DM and patients without type2DM.ST-segment resolution as an index of microvascular flow.Electrocardiographic parameters were assessed in85patients at baseline and at90minutes after PCI.Results Compared with non diabetes,patients with diabetes were less frequent complete ST-segment resolution after PCI(40%vs61%,P<0.05),and less frequent TIMI grade3flow.Left ventricular rejection function was significantly lower in DMthan in non-DM(47%vs56%,P<005).Ventricular arrhythmia was significantly higher in DM than in non-DM(32%vs15%,P<005).Conclusions Diabetic patients had less complete ST-segment resolution,suggesting impaired microvascular flow.Abnormal microvascular flow may contribute at least in part to the poorer outcomes observed in patients with diabetes and AMI.Patients with diabetes are at increased risk of death after AMI.
出处 《中国微循环》 2004年第4期236-238,共3页 Journal of Chinese Microcirculation
关键词 急性心肌梗死 糖尿病 经皮冠状动脉介入治疗 微循环 Acute myocardial infarction Diabetes Mellitus Percutaneous coronary intervention Microˉcirculation
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