非糖尿病急性心肌梗死患者早期血糖增高的意义

Clinical Significance of Early Hyperglycemia in Nondiabetic Patients with Acute Myocardial Infarction

目的:探讨非糖尿病急性心肌梗死(AMI)早期血糖增高的临床意义。方法:收集258例非糖尿病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<7.0mmol/L,n=112)、血糖轻度升高组(7.0mmol/L≤FBS<11.1mmol/L,n=82)和血糖高度升高组(FBS≥11.1mmol/L,n=64),对比分析各组患者住院并发症、病死率、梗死面积、心肌酶及心功能状况。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高于血糖正常组(P<0.01),而在心功能方面,血糖增高组低于血糖正常组(P<0.01),血糖升高程度与以上各项指标均有关。结论:非糖尿病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 nondiabetic patients with acute myocardial infarction （AMI）. Methods： The clinical data of 258 nondiabetic patients with AMI were collected and divided into 3 groups on the basis of admission fast blood glucose （FBS） level： normal group （FBS〈7.0 mmol/L, n=112）, higher FBS group （7.0 mmol/L≤FBS〈11.1 mmol/L, n=82）, and highest FBS group （FBS≥11.1 mmol/L, n=64）. The complications, mortality, infarction size, myocardial enzyme and cardiac function of the three groups＇ of patients were compared and analysed. Results： The mortality, the incidence of complication, the rate of compound myocardial infarction and the myocardial enzyme were all higher in higher FBS groups than that of normal one （P 〈 0.01）, but the cardiac function was lower in group with higher FBS than that of normal group （P 〈 0.01）. The glucose level was relevant to all above parameters. Conclusion： The phenomenon of early hyperglycemia in nondiabetic patients with AMI indicates the more serious conditions, wider area of infarction, more complications, worse prognosis and higher mortality.