急性心肌梗死患者早期血糖增高的临床意义

Clinical significance of early hyperglycemia in patients with acute myocardial infarction

目的探讨非糖尿病急性心肌梗死(AMI)患者早期血糖增高的临床意义。方法收集357例AMI患者临床资料,根据其入院空腹血糖(FBS)水平,将其分为血糖正常组(FBS<7.0 mmol/L,n=112)、血糖轻度升高组(7.0 mmol/L≤FBS<11.1 mmol/L,n=152)和血糖高度升高组(FBS≥11.1 mmol/L,n=93),对比分析各组患者住院并发症、病死率、梗死面积、心肌酶及左心室功能。结果血糖增高组患者的住院并发症、病死率、复合壁梗死发生率及心肌酶显著高于血糖正常组(P<0.01),且空腹血糖升高程度与以上各项指标成正相关。而在左室功能方面,血糖增高组显著差于正常组(P<0.01),且与血糖增高程度成负相关。结论AMI患者早期血糖增高提示病情重,梗死面积大、并发症多、预后差及病死率高。

Objective To investigate the clinical significance of early hyperglycemia in non-diabetic patients with acute myocardial infarction（AMI）. Methods A total of 357 unselected patients hospitalized with AMI were categorized according to the fast blood glucose（FBS） level into three groups： normal FBS group （FBS〈7.0 mmool/L, n =112）, higher FBS group （7.0 mmol/L≤FBSG11. 1 mmool/L, n=152）, and highest FBS group （FBS≥. 1 mmool/L, n = 93）. Complication, mortality, infarction size, myocardial enzyme and left ventricular function were compared among the three groups of the patients. Results The patients of high FBS groups were notably higher than those of normal FBS group in hospital complication, mortality, compound wall infarction incidence and myocardial enzyme（ P〈0.01）, and FBS had positive correlation with all the above items. But in left ventricular function, the patients of high FBS groups were notably lower than those of normal FBS group（ P〈0.01）. Moreover, FBS had negative correlation with left ventricular function. Conclusion The phenomenon of early hyperglycemia in the patients with AMI indicates more serious conditions, wider infarction area, more complications, worse prognosis and higher mortality.