老年糖尿病合并急性心肌梗死88例临床分析

Clinical Analysis of 88 Old Acute Cardiac Infarction Patients Complicated with Diabetic Mellitus

目的:对患糖尿病合并急性心肌梗死的老年病人进行分析,探讨糖尿病对老年人心脏的影响。方法:总结我院ICU病房收治的老年糖尿病合并急性心肌梗死患者88例(糖梗组),并以同期收治的老年非糖尿病急性心肌梗死86例(对照组)作为对照,观察其临床表现、并发症及预后。结果:糖梗组的发病年龄略高于对照组(P>0.05),经多年随诊糖梗组再梗率为27.3％,也高于对照组的10.5％(P<0.01),糖梗组的临床表现多无胸痛,症状、体征多样化,并发症多,与对照组比较,并发泵衰竭者多巳差异有显著性,但严重心律失常的发生频率无显著性差异。糖梗组病死率为对照组的2.07倍。结论:糖尿病对老年心脏的影响主要是对血管的影响,导致心肌梗死发病较早,病死率高。其次,糖尿病死亡病人的血糖峰值明显高于存活者,提示血糖浓度高低也是影响其预后的一个重要因素,治疗中应控制血糖。

Objective: To clinically nalyze 88 old cardiac infarction patients complicated with diabetic mellitus and probe the influence of diabetic mellitus on the cardiovascular system of senile patgient. Methods: Eigrty-eight old cardiac infarction patients complicated with diabetic mellitus acted as diabetic group, 86 patients only with cardiac infarction acted as control group. The clinical manifestations, complications and prognosis of them were observed. Results: The pathogenic age of car-diac infarction in diabetic group was slightly lower than that in control group (P>0.05). Most patients in diabetic group did not suffer from pectoralgia and had varied symptoms and signs. The complications in diabetic group, such as pump failure, were significantly more than those in control group. The recurence rate of cardiac infarction in diabetic group (27.3%) was higher than that in control group (10.5% ; P< 0.01). The fatality rate of cardiac infarction in diabetic group was 2.07 times that in control group. Conclusion: Diabetic mellitus may cause a low pathogenic age and a high fatality rate of cardiac infarction. Hyperglycosemia may be an important influential factor on prognosis of cardiac infarction.