急性心肌梗死患者入院血糖水平与经皮冠状动脉介入治疗后预后的关系

Admission glycaemia and outcome after percutaneous coronary intervention in patients with acute myocardial infarction

目的观察急性心肌梗死(AMI)患者随机血糖水平对介入治疗后预后的影响。方法选取急性心肌梗死患者354例,根据入院第一次随机血糖分为3组:A组:132例,血糖<7.80mmol/L;B组120例,血糖7.80～11.00mmol/L;C组102例,血糖≥11.00mmol/L。结果与A组相比,C组血胆固醇、低密度脂蛋白、甘油三酯浓度较高(P<0.05)。冠状动脉造影示B、C组多支病变比例高于A组,但差异无统计学意义(P>0.05)。B、C组校正TIMI帧数(CTFC)值高于A组(P<0.05)。B、C组主要心血管事件发生率及病死率高于A组,其中C组与A组相比差异有统计学意义(P<0.05)。结论入院随机血糖升高的急性心肌梗死患者,进行直接介入治疗后预后较差,心血管事件发生率及病死率较高。

Objective To evaluate the association between hyperglycaemia at admission and in-hospital outcomes in acute myocardial infarction （AMI） patients undergoing percutaneous coronary intervention （PCI）. Methods Three hundreds and fifty-four patients with AMI and underwent PCI were divided into 3 groups according to the glucose level on admission：group A （n=132）,7.80 mmol/L; group B （n=120）,7.80—11.00 mmol/L; group C （n=102）,≥11.00 mmol/L. Results Patients in group C had higher cholesterol,low-density lipoprotein and triglycerides levels than those in group A. Compared with group A,there were higher incidence of multi-vascular diseases and higher corrected TIMI frame count （CTFC） in angiography in group B and group C. Cardiac events and in-hospital mortality in group B and group C were higher than those of group A,while statistical difference was found between group C and group A. Conclusion Elevated admission glucose level in AMI patients with primary PCI is associated with worse prognosis,increased major adverse cardiac events and higher in-hospital mortality.