糖尿病并发急性心梗的危险因素及临床诊治方案探讨

Study on risk factors and clinical diagnosis and treatment methods of diabetes mellitus complicated with acute myocardial infarction

目的:探究糖尿病并发急性心梗的危险因素与临床诊治方案.方法:回顾性分析甘肃省兰州市武警甘肃总队医院2013-01/2014-11收治的80例单纯急性心肌梗塞患者与80例糖尿病合并急性心肌梗塞患者作为研究对象,将其分别设为对照组(n=80)与实验组(n=80),对比两组患者的临床治疗效果及并发症情况.结果:糖尿病合并急性心肌梗塞患者所在的实验组低密度脂蛋白胆固醇、甘油三酯、载脂蛋白B水平明显高于对照组,而高密度脂蛋白胆固醇低于对照组,差异具有统计学意义(P<0.05).在本次临床实验治疗的过程中,糖尿病合并急性心肌梗塞患者的不良特征与并发症情况具体包括:胸痛胸闷、呼吸困难、恶心呕吐、心源性休克、心律失常、急性左心衰、死亡等,糖尿病合并急性心肌梗塞患者发生这些疾病症状与并发症状的概率明显高于单纯急性心肌梗塞患者,同时,糖尿病合并急性心肌梗塞患者的病死率也高于单纯急性心肌梗塞患者,差异具有统计学意义(P<0.05).结论:糖尿病是心肌梗死的独立危险因素,高载脂蛋白更是糖尿病并发心肌梗死患者的独立危险因素,在我国临床医学领域,糖尿病并发急性心梗的致死率较高,在临床治疗过程中需要重点关注.

AIM： To investigate the risk factors and clinical diagnosis and treatment methods of diabetes mellitus complicated with acute myocardial infarction. METHODS： A total of 160cases（ 80 cases with acute myocardial infarction and 80 cases with diabetes mellitus complicated with acute myocardial infarction）admitted into our hospital from January 2013 to November 2014 were selected as research objects and retrospectively analyzed,which were divided into the control group（ 80 cases with acute myocardial infarction） and the experimental group（ 80 cases with diabetes mellitus complicated with acute myocardial infarction）.The clinical therapeutic effect and complications were compared.RESULTS： The low density lipoprotein cholesterin,triglyceride and apolipoprotein B levels were significantly higher than that of control group,while high density lipoprotein cholesterol below control group,and the difference was statistically significant（ P〈0. 05）; negative characteristics and complications of patients with diabetes mellitus complicated with acute myocardial infarction specifically as follows. Chest pain or distress,dyspnea,nausea and vomiting,cardiac shock,arrhythmia,acute left heart failure,death and so on. The probability of occurrence of disease symptoms and concurrent symptoms in diabetes mellitus complicated with acute myocardial infarction patients were significantly higher than that of simple acute myocardial infarction patients. Meanwhile,the fatality rate of diabetes mellitus complicated with acute myocardial infarction patients were significantly higher than that of simple acute myocardial infarction patients,and the difference was statistically significant（ P 0. 05）. CONCLUSION： Diabetes mellitus is an independent risk factor for myocardial infarction,and hyperapolipoprotein is an independent risk factor for diabetes mellitus complicated with myocardial infarction. In the field of medicine,the fatality rate of diabetes mellitus complicated with acute myocardial infarction is higher,therefore we should focus on this in the clinical treatment.