糖尿病合并急性心肌梗塞89例临床分析

ACUTE MYOCARDIAL INFARCTION WITH DIABETES MELLITUS: A CLINICAL STUDY OF 89 CASES

报告的急性心肌梗塞(AMI)941例患者中89例合并糖尿病。此组病例AMI发病年龄、住院死亡率及复发率均高于非糖尿病组;合并高血压和高脂血症者多。AMI时的临床特点为无痛性心肌梗塞多、心衰发生多。认为糖尿病患者除有严重的冠状动脉硬化及植物神经病变外,还有弥漫性心肌病变及心肌内微小血管病变。因此,糖尿病患者AMI的病情重、预后差。

Among 941 patients of AMI admitted in the period from Jan 1969 to Jan 1989, 89 cases were complicated with diabetes mellitus (9.5%). The diabetic patients are older than non-diabetic, the occurrence of reinfarction and complications during AMI were more frequent and the mortality was higher incidence of complication of hypertension (69.7%) and hyperlipi-demia(39.3%).The clinical characteristics of AMI in diabetic patients are: higher occurrence of silent myo-cardial infarction and more frequent occurrence of heart failure. Recently, evidences from clinic-pathologic and epidemiologic investigations and experimental studies suggest that diabetes mellitus is associated not only with severe coronary atherosclerosis, but also microangiopathy, disorders in vegetative nervous system, and pathology of the myocardium. Therefore effective measures for prevention and treatment of diabetes is very important to decrease the mortality of AMI.