血糖对ICU心肌梗死患者生存状况的影响

Effect of blood glucose on the survival status of patients with myocardial infarction in ICU

目的 探讨血糖对ICU心肌梗死患者生存状况的影响.方法 回顾性分析2012年3月至2013年3月152例心肌梗死患者,随访确定3年的生存率,根据生存情况将患者分为生存组和死亡组,比较两组患者的性别比例、年龄分布、心率、是否合并高血压、是否合并吸烟、血糖、白细胞计数、左心射血分数（LVEF）、心功能分级,确定影响ICU心肌梗死患者生存状况的相关因素和独立影响因素.根据血糖高低将患者分为高血糖组和低血糖组,比较两组患者的年龄、性别、是否合并高血压、是否合并吸烟史、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）差异;比较两组患者的住院时间、住院期间并发症,心力衰竭发生比例、心室颤动发生率、心室期前收缩、3年的存活率.结果 通过单因素分析,年龄分布、血糖、白细胞计数、LVEF、心功能分级均ICU心肌梗死患者生存状况的相关影响因素,通过COX多因素分析,血糖、LVEF、心功能分级均为ICU心肌梗死患者生存状况的独立影响因素;高血糖组和低血糖组性别比例、年龄分布、是否合并高血压、是否合并吸烟史、TC、TG、LDL-C比较差异未见统计学意义;低血糖组住院期间并发症发生比例显著低于高血糖组,差异有统计学意义（P〈0.05）;低血糖组住院时间显著低于高血糖组,低血糖组1年、2年、3年的生存率显著高于高血糖组,差异有统计学意义（P〈0.05）.结论 血糖升高的ICU心肌梗死患者发生并发症的概率显著提升,3年存活率显著减低,为了有效改善ICU心肌梗死患者的生存状况,应对入院心肌梗死患者及时检测血糖并给予对症治疗.

Objective To investigate the effect of blood glucose on the survival status of patients with myocardial infarction in ICU.Methods A retrospective analysis of 152 patients with myocardial infarction treated in ICU from March 2012 to March 2013, the patients were divided into survival group and death group according to the survival rate of 3 years.Gender, age distribution, heart rate, hypertension, smoking, blood glucose, white blood cell count, left ventricular ejection fraction （LVEF）, cardiac function classification were compared between the two groups.The patients were divided into high blood glucose group and hypoglycemia group according to the level of blood glucose, age, sex, hypertension, and smoking history, TC, TG, LDL-C difference were compared between the two groups;Hospitalization, hospitalization period complications, incidence of heart failure, the incidence of ventricular fibrillation, ventricular premature contraction, the survival rate of 3 years was compared.Results By single factor analysis, age distribution, blood glucose, white blood cell count, left ventricular ejection fraction （LVEF） were related factors of heart function classification ICU survival status of patients with myocardial infarction.Buy COX multivariate analysis, blood glucose.the left ventricular ejection fraction （LVEF） heart function classification were independent risk factors of ICU survival status of patients with myocardial infarction;sex ratio, high blood glucose group and hypoglycemia group age distribution, hypertension, and smoking history, TC, TG, had no significant difference in the LDL-C difference;the in-hospital complication rate of hypoglycemia was significantly lower than that of the high glucose group, and the difference was significant（P〈0.05）;hospitalization time of patients with hypoglycemia group was significantly lower than that of the high glucose group, the 1 years, 2 years, 3 years survival rate in hypoglycemia group was significantly higher than those of the high glucose group, and the differences were significant（P〈0.05）.Conclusions Hyperglycemia ICU patients with myocardial infarction have higher complication retes, and the 3 year survival rate is significantly lower, in order to effectively improve the survival condition, in patients with myocardial infarction shoud be given timely detection of blood glucose and symptomatic treatment at admission.