血糖浓度增高对急性心肌梗塞预后的影响

The Influence of the Increased Blood Glucose Concentration to the Prognosis of Acute Myocardial Infarction

目的:回顾性地了解无论是否伴有糖尿病,血糖浓度增高对急性心肌梗塞住院病死率及心梗后心衰、心源性休克的影响。方法:1990年1月～2000年10月我院心肌梗塞住院病人100例,将入院时血糖浓度<6.6mmol/L作为A组。入院时血糖浓度增高在6.6～11.1mmol/L为B组。入院时血糖浓度>11.1mmol/L为C组,分别计算各组发生心衰、心源性休克的百分率及住院病死率。结果:A组心衰发生率10.71％,心源性休克发生率3.57％,住院病死率3.57％;B组心衰发生率41.18％,心源性休克发生率29.41％,住院病死率26.47％;C组心衰发生率52.63％,心源性休克发生率31.58％,住院病死率26.32％。B组、C组心衰发生率、心源性休克发生率及住院病死率比A组明显增加,差异有显著性。而B组与C组心衰发生率、心源性休克发生率及住院病死率无显著性差异。结论:血糖浓度增高,心衰、心源性休克发生率及住院病死率明显增高。

Objective: To assess the risk of in -hospital mortality, congestive heart failure and cardiogenic shock after acute myo-cardial infarction in patients with and without diabetes who had hyperglycaemia on admission. Methods: 100 in-hospital patients of myocardial infarction at our hospital from January, 1990 to October, 2000 were selected and divided into 3 groups. Croup A was the patients who had blood glucose concentrations on admission below 6.6mmol/L. Croup B was the patients who had blood glucose concentrations on admission in the range of 6.6 ~ 11.1 mmol/L. Group C was the patients whose blood glucose concentrations were more than 11.1 mmol/L. The percentages of congestive heart failure, cardiogenic shock and in-hospital mortality in every group were calculated. Results: The percentage of congestive heart failure in group A was 10.71 % , the percentage of cardiogenic shock was 3.57% , and the in-hospital mortality was 3.57% , In group B, the same items were 41.18% , 29.41% and 26.47%,respectively. And in group C, the data were 52.63% , 31.58% and 26.32% . The percentage of congestive heart failure, cardiogenic shock and in-hospital mortality in group B or group C were significantly more increased compared with those in group A. While the data in group B were not obviously different to those in group C. Conclusion: The percentage of congestive heart failure, cardiogenic shock and in-hospital mortality were apparently raised after myocardial infarction with increased blood glucose concentrations.