合并糖尿病的急性ST段抬高型心肌梗死的临床特征及预后分析

Clinical Characteristics and Prognosis of STEMI with Diabetes Mellitus

目的探析合并糖尿病的急性ST段抬高型心肌梗死的临床特征及预后情况。方法从沈阳市红十字会医院2017年2月至2019年1月收治的急性ST段抬高型心肌梗死合并糖尿病患者中选择102例进行研究,设定为试验组,另选择同时间段内的单纯急性ST段抬高型心肌梗死102例,设定为对照组,比较两组患者的一般临床特征、心脏血管病变特点及预后状况。结果试验组患者的年龄大于对照组,吸烟患者比例低于对照组,合并高血压、合并高血脂、心功能分级≥Ⅲ级患者比例均高于对照组,P<0.05;试验组单支病变患者比例低于对照组,三支病变、合并左主干病变、慢血流/无复流患者比例均大于对照组(P<0.05),两组双支病变患者比例差异无统计学意义,P>0.05;试验组患者的住院期间心源性死亡、再次血运重建、心力衰竭发生率高于对照组(P<0.05),但心源性死亡、再发心肌梗死发生率两组间差异无统计学意义,P>0.05。结论急性ST段抬高型心肌梗死合并糖尿病患者病情更为危重,心功能等级较高,且多为高龄患者,病情复杂,住院期间病死率高,但早期介入治疗后再发心肌梗死、心源性死亡的患者比例未见明显升高,预后尚可。

Objective To explore the clinical characteristics and prognosis of acute ST segment elevation myocardial infarction(STEMI)with diabetes mellitus(DM).Methods A total of 102 patients with STEMI with DM were selected from Shenyang Red Cross Hospital from February 2017 to January 2019.They were set as the experimental group,and 102 patients with simple STEMI in the same period were set as the control group.The general clinical characteristics,the characteristics of cardiovascular disease and the prognosis of the two groups were compared.Results The patients in the experimental group were older than those in the control group,the proportion of smoking was lower than that in the control group,and the proportion of hypertension,hyperlipidemia and cardiac function grade≥grade III was higher than that in the control group(P<0.05).The proportion of single vessel lesions in the experimental group was lower than that in the control group,and the proportion of three vessel lesions,combined with left main artery lesions,slow flow/no reflow was higher than that in the control group(P<0.05),there was no significant difference between the two groups in the proportion of double vessel disease(P>0.05).The mortality of patients in the experimental group during hospitalization was higher than that in the control group,and the incidence of revascularization and heart failure 12 months after operation was higher than that in the control group(P<0.05),but there was no significant difference between the two groups in the incidence of cardiac death and recurrent myocardial infarction 12 months after operation(P>0.05).Conclusion Patients with STEMI with DM are more critical,with higher cardiac function level,and most of them are elderly patients,with complex condition and high mortality during hospitalization.However,there is no significant increase in recurrent myocardial infarction and cardiogenic mortality after early intervention,and the prognosis is fair.