急性心肌梗死后血糖升高患者的预后分析

Prognosis of Hyperglycemia after Acute Myocardial Infarction

目的探讨急性心肌梗死(AMI)后血糖升高患者的临床特点及预后。方法将116例AMI患者根据空腹血糖(FPG)水平分为血糖正常组(66例)和血糖升高组(50例),比较两组患者的临床特点、并发症及病死率等。结果 AMI后血糖升高组与血糖正常组之间严重的心律失常、心力衰竭、心源性休克、大面积梗死、冠状动脉2支及3支病变发生率及病死率比较,差异均有统计学意义(P<0.05)。血糖升高组FPG和肌酸磷酸激酶(CK)水平均明显多于血糖正常组,差异均有统计学意义(P<0.01)。血糖升高组的左冠状动脉前降支近段、左冠状动脉回旋支近段和右冠状动脉近段梗死面积均明显多于血糖正常组,差异均有统计学意义(P<0.05)。结论 AMI患者血糖升高,临床症状较重,预后较差。积极控制血糖水平,预防糖尿病的发生,对预防和控制并发症,降低患者的病死率有十分重要的意义。

Objective To investigate the clinical features and prognosis of hyperglycemia after acute myocardial infarction（AMI）.Methods One hundred sixteen AMI patients were divided,according to fasting blood glucose level,into groups normal（n=66） and hyperglycemia（n=50）.Clinical features,complications and mortalities were compared between 2 groups.Results There was significant difference in severe arrhythmias,heart failure,cardiogenic shock,mortality and lesion incidence in 2 or 3 coronary arteries between 2 groups（P〈0.05）.Fasting blood glucose and creatine phosphokinase were higher in hyperglycemia group than in normal groups（P〈0.01）,and proximal LAD,LCX and RCA higher（P〈0.05）.Conclusion Blood glucose level increases in AMI patients with severe clinical symptoms and poor prognosis.Active control of blood glucose,prevention of diabetes and lowering of mortality are of importance in prevention and control of complications.