新诊断的糖代谢异常对急性心肌梗死后左心室射血分数的影响

Effect of newly diagnosed abnormal glycometabolism on left ventricular ejection fraction after acute myocardial infarction

目的观察新诊断的糖代谢异常对急性心肌梗死后LVEF的影响。方法入选首次急性心肌梗死患者161例(对无糖尿病病史的患者发病7天后行口服葡萄糖耐量试验),根据检查结果及是否有糖尿病病史,分为正常糖耐量组(37例)、糖调节异常组(46例)、新诊断糖尿病组(37例)和既往已确诊糖尿病组(41例)。4组患者分别于发病后72 h内、30天行三维超声心动图检查评价左心室功能。结果糖调节异常组、新诊断糖尿病组和既往已确诊糖尿病组72 h内及30天随访时的LVEF均明显低于正常糖耐量组(72 h:(45.1±7.1)%、(45.0±7.2)%、(45.1±7.2)%vs(48.9±6.8)%,P<0.05;30天:(47.0±7.5)%、(47.8±7.3)%、(48.0±7.4)%vs (53.4±6.4)%,P<0.05]。结论新诊断的糖代谢异常也对急性心肌梗死后左心室功能产生不利的影响。

Objective To investigate the effect of newly diagnosed abnormal glycometabolism on left ventricular ejection fraction（LVEF） after acute myocardial infarction（AMI ）. Methods A series of 161 patients with first acute myocardial infarction were enrolled. The patients without diabetes history underwent oral glucose tolerance test（OGTT）. The patients were grouped according to glycometabolism status： normal glucose tolerance （n=37）, impaired glucose regulation （n = 46 ）, newly diagnosed diabetes mellitus （n = 37） and previously known diabetes mellitus （n = 41）. Three dimensional echocardiography was performed on admission and 30 days after AMI onset. Results Compared with normal glucose tolerance group, LVEF of impaired glucose regulation, newly diagnosed diabetes mellitus and previously known diabetes mellitus groups were lower on admission and 30 days after AMI onset [on admission：（45.1±7.1）%, （45.0±7.2）%, （45.1±7.2） % vs （48.9＋6.8） %, P 〈 0.05 ;30 days after AMI： （47.0±7.5）%, （47.8±7.3）%,（48.0±7.4） % vs （58.4±6.4）%, P 〈 0.05]. Conclusions Abnormal glycometabolism, whether newly diagnosed or previously known,is associated with decreased LVEF after AMI onset.