急性心肌梗塞合并糖尿病患者的冠状动脉造影及临床特点分析

Analysis the relationship of coronary angiography and clinical characters of acute myocardial infarction patients complicated with diabetes mellitus

目的分析急性心肌梗塞（ＡＭＩ）合并糖尿病患者的冠状动脉造影特点以及与临床之间的关系。方法共有３９０例急性心肌梗塞患者，其中８１例合并有糖尿病，３０９例未合并糖尿病。患者均在ＡＭＩ发病３小时至２周行冠状动脉造影及血脂分析。结果ＡＭＩ合并有糖尿病组平均年龄及年龄≥７０岁、女性患者、合并有高血压及前壁心肌梗死的发生率较非糖尿病组多（Ｐ＜０．０５或＜０．０１），同时合并有糖尿病组患者总胆固醇和甘油三酯水平也高于非糖尿病组患者（Ｐ＜０．０５）。冠状动脉造影显示糖尿病组冠脉血管多支病变、弥漫性病变、重度病变以及左主干病变均多于非糖尿病组患者（Ｐ＜０．０５或＜０．０１）。结论ＡＭＩ合并糖尿病患者年龄大、女性较多、前壁心肌梗塞发生率高，且多合并有高血压及脂质代谢紊乱，同时冠状动脉病变严重且广泛，故应重视糖尿病的预防及治疗。

Objective To analyze the relationship of coronary angiography (CAG) and clinicalcharacters of AMI patients that still suffered diabetes mellitus (DM). Methods We analyzed 390 AMIpatients, 81 of them suffered DM. All of them accepted CAG and serum lipids examination. ResultsThe non-DM group had a lower mean age, fewer that is over 70 years, fewer females, fewer that suffered hypertension or myocardial infarction in preferior wall, lower level of total cholesterol and triglyceride than the DM group (P<0.01 or P<0. 05). CAG showed more patietns of DM group had a coronary injured of multivessel diverse coronary changes, serious and left main coronary diseases than thatof non-DM group (P<0.01 or P<0. 05 ). Conclusion AMI patients that complicated DM is older,more females, more preferior wall MI, and is likely to suffer hypertension or higer serum lipids, alsothe serious and diverse coronary diseases, we should emphasize the precaution and treatment of DM.