非糖尿病急性心肌梗死患者不同血糖水平对预后的影响

The Effect of the Blood Sugar Level on Prognosis of Acute Myocardial Infarction in Non- Diabetes Patients

目的探讨非糖尿病急性心肌梗死（AMI）患者血糖水平对预后的影响。方法将122例AMI患者随机分为正常血糖组46例（空腹血糖≤6．1mmol／L）和血糖升高1组（6．1mmol／L〈空腹血糖≤8．0mmol／L）38例、血糖升高2组（8．0mmol／L〈空腹血糖≤11．1mmol／L）27例和血糖升高3组（空腹血糖〉11．1mmol／L）11例，在人院第4周统计2组患者肌酸激酶（CK）、门冬氨酸转氨酶（AST）、乳酸脱氢酶（LDH），心电图ST段恢复时间以及恶性心律失常、心力衰竭、心源性病死发生率的差异。结果与正常血糖组比较，血糖升高1组在心肌酶和心电图恢复时间，恶性心律失常、心力衰竭和心源性病死率无明显差异（P〉0．05）；血糖升高2组CK、AST恢复时间明显延长，恶性心律失常和心源性病死率明显升高，有显著性差异（P〈0．05）；血糖升高3组CK、AST、LDH和ST段恢复时间明显延长，恶性心律失常、心力衰竭和心源性病死率明显升高，有显著性差异（P〈0．05）。结论非糖尿病AMI患者血糖〉8．0mmol／L以上时，随着血糖升高，预后越差。

Objective To approach the effect of the blood sugar level on prognosis of acute myocardial infarction（AMI） in non - diabetes patients. Methods 122 cases of AMI were devided into four groups randomly, the blood - fasting sugar of the normal blood sugar group （ n = 46 ） were under 6. 1 mmol/L, while the first high blood sugar group （n = 38 ） were from 6.1 mmol/L to 8.0 mmol/L, the second high blood sugar group（ n = 27） were from 8.0mmol/L to 11.1 mmol/L, and the third high blood sugar group（ n = 11 ） were above 11.1 mmol/L. Tthe recovery time of creatinkinase（ CK）, aspartate ami- notransferase （AST）, lactate dehydrogenase （LDH）, and the incidence rate of malignant arrhythmia, myocardial failure and cardiogenic fatality were observed. Results Compared with the normal blood sugar group, the indexes of first high blood sugar group were of no obvious difference （ P 〉 0.05 ） ; the recovery time of the CK and AST were extended, and the incidence rate of malignant arrhythmia and cardiogenic fatality were increased in the second high blood sugar group （P 〈 0.05 ） ; the recovery time of the cardiac creatase and electrocardiogram were extended, while the incidence rate of malignant arrhythmia, myocar- dial failure and cardiogenic fatality were increased in the third high blood sugar group （ P 〈 0.05 or P 〈 0. 01 ）. Conclusion For AMI non - diabetes patients with blood sugar over 8. OmmoL/L, the higher the blood sugar, the worse the prognosis.