应激性高血糖对急性ST段抬高型心肌梗死患者不良心血管事件发生和远期预后的影响

Effects of stress hyperglycemia on the occurrence and long-term prognosis of adverse cardiovascular events in patients with acute ST segment elevation myocardial infarction

目的探究应激性高血糖对急性ST段抬高型心肌梗死患者不良心血管事件发生和远期预后的影响。方法选取2015年1月至2017年1月于本院诊断为急性ST段抬高型心肌梗死非糖尿病患者160例作为研究对象,根据检测结果分为观察组(n=52)和对照组(n=108)。比较两组临床结局,根据患者临床结局分为预后不良组及预后良好组,确定不良事件的危险因素。结果观察组恶性心律失常、心衰、再发心梗、死亡等发生率均明显高于对照组(P<0.05);总胆固醇、甘油三酯、应激血糖、高血压史、BMI、心功能、病变长度、NT-proBNP为急性ST段抬高型心肌梗死非糖尿病患者不良事件发生的独立危险因素。结论应激性高血糖会影响急性ST段抬高型心肌梗死患者不良心血管事件发生及远期预后结局。

Objective To study the effect of stress hyperglycemia on adverse cardiovascular events and long-term prognosis in patients with acute ST segment elevation myocardial infarction.Methods From January 2015 to January 2017,160 patients with ST segment elevation myocardial infarction diagnosed as non diabetic in our hospital were selected as research subjects.According to the test results,they were divided into observation group(n=52)and control group(n=108).Comparing the clinical outcomes of the two groups,the patients were divided poor prognosis group and good prognosis group according to the outcome.The risk factors of adverse events were determined.Results The incidence of malignant arrhythmia,heart failure,recurrent myocardial infarction and death in the observation group were significantly higher than those in the control group(P<0.05).Through single factor and multi factor analysis,it was found that total cholesterol,triglyceride,stress blood glucose,history of hypertension,BMI,cardiac function,length of disease change,NT-proBNP were independent adverse events in non diabetic patients with ST segment elevation myocardial infarction risk factors.Conclusion Stress hyperglycemia can affect the occurrence of adverse cardiovascular events and long-term prognosis in patients with acute ST segment elevation myocardial infarction.