ST段抬高的急性心肌梗死患者入院即刻随机血糖水平与预后相关性分析

Impact of admission blood glucose on prognosis of ST-segment elevation myocardial infarction

目的观察急性ST段抬高的心肌梗死(STEMI)患者血糖水平对其心功能、预后及1年后病死率的影响。方法连续入选2006年1月～2008年10月间所有符合STEMI患者217例,根据入院后即刻随机血糖分A组(血糖<7.8mmol/L),B组[血糖(7.8～10.9)mmol/L],C组(血糖≥11.0mmol/L)三组。观察心脏不良事件、心因性死亡、再次心梗、心绞痛复发情况。结果心功能等级随着糖代谢异常程度的增加而增加。三组血糖水平、有糖尿病史患者发生心血管不良事件比较差异有显著意义。Logistic回归模型结果显示血糖水平是STEMI患者心脏事件发生、死亡、心绞痛复发的危险因素(P<0.05)。结论伴高血糖的急性ST段抬高心肌梗死(STEMI)患者心功能及预后较差。

Objective To investigate the impact of admission blood glucose in patients with acute ST-segment elevation myocardial infarction （STEMI）. Methods A total of 217 patients with STEMI between January 2006 and October 2008 in car diology department were divided into 3 groups according to the levels of blood glucose on admission： group A, 〈7.8 mmol/L ; groupB, （7.8-10.9）mmol/L; group C, ≥ 11.0 mmol/L. To collect and analyze the major adverse cardiac events, the cumulative survival rates and the correlated risk factors . Results At the end of the one-year foUow-up ,the incidences of major adverse cardial events, recurring angina pectoris, one-year mortality rate of group C were significantly higher than those in group A and B （P 〈 0.05）. The logistic regression model analysis showed that the blood glucose was an independent risk factor for incidence of major adverse cardiac events ,all causse mortality and recurring angina pectoris （P 〈 0.05）. Conclusion Hyperglycemia at admission was associated with poor cardiac function and prognosis in patients with acute STEMI.