2型糖尿病并发急性心肌梗死的临床与溶栓疗效

Clinical features and thrombolytic effects in patients with type 2 diabetes mellitus and acute myocardial infarction

目的探讨2型糖尿病并发急性心肌梗死的临床特征与静脉溶栓的疗效。方法急性心肌梗死住院病例186例,并发2型糖尿病69例(糖尿病组),未合并糖尿病117例(对照组),均在发病后12 h内进行尿激酶溶栓治疗,比较两组患者的临床特征和静脉溶栓的近期疗效。结果糖尿病组患者无痛性心肌梗死和多部位梗死的发生率明显高于对照组(P<0．05)。溶栓后糖尿病组的血管再通率明显低于对照组(P< 0．05),病死率、再梗死和合并症的发生率均高于对照组(P<0．05)。结论2型糖尿病并发急性心肌梗死患者的病情较重,静脉溶栓近期疗效较差。

Objectives To investigate the clinical features in type 2 diabetic patients with acute myocardial infarction（AMI） and to assess the therapeutic effects of intravenous thrombolysis. Methods One hundred and eighty-six patients with AMI were collected and divided into two groups, DM group （with diabetes, n=69） and control group （non-diabetes, n=117）. All the patients were treated with UK within 12 hours from symptom onset. Clinical features of DM group were compared with those of control group. Results DM group had significantly higher incidences of painless and multiple-site infarction than control group （P〈0.05）. Additionally, DM group had significantly lower reperfusions than control group （P〈0.05） after thrombolytic therapy. Furthermore, the former was at significantly higher risks of mortality, reinfarction and complications than the latter（P〈0.05）. Conclusions Clinical situations of patients with diabetes and AMI arc serious. Consequently, recent effect of intravenous thrombolysis is inferior.