急性心肌梗死合并应激性高血糖对溶栓再通的影响

The Effect of the Thrombolysis on Patency of Acute Myocardial Infarction Associated Stress High Blood Sugar

【目的】探讨急性心肌梗死(AMI)患者合并应激性高血糖时对用尿激酶(UK)静脉溶栓治疗后冠状动脉再通的影响。【方法】排除糖尿病(DM)后,将临床评价有溶栓指征的64例AMI患者,根据溶栓前有无合并应激性高血糖分两组,不合并高血糖者为A组,合并高血糖者为B组。比较两组溶栓后CK-MB峰值前移、再灌注心律失常、S-T段下降≥50%、心脏事件发生情况及出院时左心室射血分数(LVEF)。【结果】A组与B组相比:CK峰值前移,再灌注心律失常,2h内S-T段下降≥50%等再通指征发生率明显高;心脏事件明显减少;LVEF亦显著增加;平均住院日减少,两组相比较有显著差异。【结论】溶栓治疗前未合并高血糖的患者,冠状动脉再通率高,心肌能获得更有效的再灌注。合并应激性高血糖患者再通率低,近期预后差。

[Objective]To investigate the effect urokinase（UK） thrombolysis on the patency of coronary artery in acute myocardial infarction（AMI） patients with high stress blood sugar. [Methods]Excepting diabe tes mellitus （DM）, 60 cases of AMI were divided into two groups：group A,non-high blood sugar, group B, stress high blood sugar. The moving forward of CK-MB peak value, reperfusion arrhythmia , S-T dropped≥50% ,heart events, LVEF were compared at discharge. [Results]The patency rate increased obviously in group A. Ck peak value moved forward, reperfusion arrhythmia, S-T ropped≥50% in 2 hours, heart affairs decreased obviously. LVEF increased significantly, average hospitalization time decreased. Two groups had significant difference. [Conclusion]The patency of coronary artery with non-high blood sugar before thrombolysis is higher,the myocardial can acquire valid reperfusion. The patency rate of patient with high blood sugar is low, early clinical outcome is bad.