经皮冠脉介入治疗急性心肌梗死合并2型糖尿病患者的效果及对心血管不良事件的影响

Effect of percutaneous coronary intervention on patients with acute myocardial infarction and type 2 diabetes mellitus and its influence on adverse cardiovascular events

目的探讨经皮冠脉介入(PCI)治疗急性心肌梗死(AMI)合并2型糖尿病(T2MD)患者的效果及对心血管不良事件的影响。方法选取2020年1月至2021年1月本院收治的50例AMI患者作为研究对象,根据是否合并T2MD将其分为对照组(未合并T2MD,30例)和观察组(合并T2MD,20例)。两组患者均行PCI治疗。比较两组患者的疗效指标、心功能指标及心血管不良事件发生情况。结果两组的PCI即刻成功率及TIMI血流3级率比较,差异无统计学意义(P>0.05);观察组的多支血管病变率明显高于对照组(P<0.05)。手术前,两组的LVEF、LVEDD比较,差异无统计学意义(P>0.05);手术后,对照组的LVEF明显高于术前(P<0.05);手术后,两组的LVEF、LVEDD比较,差异无统计学意义(P>0.05)。术后1年,观察组的心源性死亡、心力衰竭及心血管不良事件总发生率明显高于对照组(P<0.05)。结论PCI治疗AMI合并T2MD患者具有一定安全性与可行性,但术后患者心血管不良事件发生率较高,因此在治疗过程中需重视患者的血糖变化情况,并对合并糖尿病的患者给予降糖治疗,以提升预后效果。

Objective To investigate the effect of percutaneous coronary intervention(PCI)on patients with acute myocardial infarction(AMI)and type 2 diabetes mellitus(T2MD)and its influence on adverse cardiovascular events.Methods A total of 50 AMI patients admitted in our hospital from January 2020 to January 2021 were selected as the research object,and divided into control group(without T2MD,30 cases)and observation group(with T2MD,20 cases)according to whether the patient had T2MD or not.Both groups were given PCI treatment.The efficacy indexes,cardiac function indexes and the occurrence of adverse cardiovascular events were compared between the two groups.Results There were no significant differences in the PCI immediate success rate and rate of TIMI blood flow grade 3 between the two groups(P>0.05);the multivessel disease rate in the observation group was significantly higher than that in the control group(P<0.05).Before surgery,there were no significant differences in LVEF and LVEDD between the two groups(P>0.05);after surgery,the LVEF in the control group was significantly higher than that before surgery(P<0.05);after operation,there were no significant differences in LVEF and LVEDD between the two groups(P>0.05).One year after operation,the incidences of cardiac death,heart failure and the total incidence of adverse cardiovascular events in the observation group were significantly higher than those in the control group(P<0.05).Conclusion PCI for patients with AMI and T2MD has certain safety and feasibility,but the incidence of adverse cardiovascular events in postoperative patients is high.Therefore,it is necessary to pay attention to the changes of blood glucose in patients during the treatment,and give hypoglycemic treatment to patients with diabetes mellitus,so as to improve the prognosis.