非糖尿病患者的高血糖状态对ST段抬高型心肌梗死预后的预测作用

Non-diabetic patients with hyperglycemia state of the ST-segment elevation myocardial infarction in predicting prognosis

目的验证非糖尿病的ST段抬高型心肌梗死(STEMI)患者的血糖升高是否有助于短期预后评估。方法回顾性分析270例非糖尿病的ST段抬高型心肌梗死患者的临床资料,根据发病后是否发生高血糖分为血糖升高组和血糖正常组,前者根据血糖升高程度和持续时间分别再分为血糖轻中等程度升高、显著升高亚组,以及一过性血糖升高、血糖持续升高亚组。分别比较组间、亚组间以及组-亚组间短期病死率和发生恶性心律失常比例的差别。结果血糖升高组短期病死率高于血糖正常组。血糖显著升高亚组病死率和恶性心律失常发生率高于血糖轻中等程度升高亚组及血糖正常组。血糖持续性升高亚组病死率和恶性心律失常发生率高于血糖一过性升高亚组及血糖正常组。结论对非糖尿病的ST段抬高型心肌梗死患者,高血糖和患者短期预后有关。血糖升高水平越高,持续时间越久,预后越差。

Objective This article aimed to identify wether hyperglycemia in ST - elevation myocardial infarction patients without diabetes could be helpful for the evaluation of the short - term prognosis. Methods Clinical data from 270 cases of ST - elevation myocardial infarction without diabetes were analysised retrospectively. According to presentation of hyper- glycemia or not, data were divided into hyperglycemia group and normal plasma glucose group. Furthermore, data from hyper- glycemia were sub - grouped into mild - moderate hyperglcemia/severe hyperglycemia, and transient/ persistent hyperglycemia subgroups, by the difference of plasma glucose and hyperglycemia lasting time. The difference of mortaliy and malignanct arrhythmia between groups and subgroups were compared. Results Mortality in hyperglycemia group was higher than in normal plasma glucose group. Mortality and malignant arrhythmia rate in severe hyperglycemia subgroup was both higher than in mild -moderate hypergleemia subgroup and normal plasma glucose group. And so were in persistent hyperglycemia subgroup than in transient hyperglycemia subgroup and normal plasma glucose group. Conclusion In ST - elevation myocardial infarction patients without diabetes, hyperglycemia was associated with short - term prognosis. The higher and longer plasma glucose is, the worse prognosis is.