糖尿病对急性心肌梗死病死率的影响

Effect of diabetes mellitus on the mortality of patients with acute myocardial infarction during hospitalization

目的探讨糖尿病对急性心肌梗死(AMI)病死率的影响。方法在624例AMI患者中,有糖尿病者136例为A组,非糖尿病者488例为B组,然后将两组的发病年龄、临床特征及并发症进行比较,并对可能影响AMI患者住院病死率的因素进行多因素回归分析。结果与非糖尿病组相比,糖尿病组患者年龄较大[(66±10)岁比(64±9)岁,P<0.01],空腹血糖较高[(10.8±3.9)mmol/L比(5.3±1.5)mmol/L,P<0.01],心功能≥KillipⅢ级者较多(12.5%比6.1%,P<0.01),A组发生的高血压、血脂异常及心律失常明显高于B组,两组之间比较差异有统计学意义(P<0.05),且A组患者住院病死率显著高于B组(15.4%比5.9%,P<0.01)。结论糖尿病是影响AMI患者住院病死率的独立危险因素。

Objective To investigate the diabetes mellitus on the mortality of patients with acute myocardial infarction（AMI） during hospitalization. Methods Among 624 case with AMI,136 cases with diabetes mellitus were in group A,the others were in group B,and then compare the age,the clinic behavior and complication between the two groups.To identify risk factors that are predictive of in-hospital death,multivariate logistic regression analysis was used.Results Compared with those non-diabetes mellitus,the diabetes mellitus were substantially older[（66±9）]vs（64±9） years,P〈0.01],had a high level of fasting glucose[（10.8±3.9）vs（5.3±1.5）mmol/L,P〈0.01）].Patients with killip class greater than or equal to Ⅲ（12.5% vs 6.1%,P〈0.01） were more common in group A than in group B.The cases with hypertension,hyperlipidemia and cardiac arrhythmias in group A had obvious differences between the two groups（P〈0.05）.An increased mortality was demonstrated in group A during the hospitalization phase of AMI（15.4% vs 5.9%,P〈0.01）.Conclusion Diabetes mellitus is an independent predictor of in-hospital death in hospitalized patients with AMI.