入院时血糖水平对ST段抬高型急性心肌梗死早期溶栓治疗的影响

目的:观察入院时血糖浓度对急性ST段抬高型心肌梗死(STEMI)患者急诊溶栓治疗的影响。方法:入选STEMI患者132例,分为血糖≤7.1mmol/L组(血糖正常组),7.1～11.1mmol/L组(血糖偏高组),血糖≥11.1mmol/L组(高血糖组)。所有患者于心肌梗死发作3h内采用rt-PA进行静脉溶栓。观察各组血管再通指标﹑溶栓后出血并发症及终点事件发生率。结果:血糖正常组﹑血糖偏高组﹑高血糖组在溶栓后90min时的再通率分别为78.8%、66.0%、52.2%,差异有统计学意义(P<0.05)。溶栓治疗后30d内,3组出血并发症差异无统计学意义(P>0.05),而高血糖组再梗死、心力衰竭及死亡的发生率明显增加(P<0.05)。结论:高血糖水平可降低STEMI患者早期溶栓的再通率,增加终点事件发生率。

Impact of blood glucose on admission to intravenous thrombolysis in patients with ST-segment elevation myocardial infarction

Objective:To observe the effect of blood glucose(BG) level on admission to thrombolysis in patients with ST-segment elevation myocardial infarction(STEMI).Method:A total of 132 patients with STEMI were admitted in our department and were divided into three groups according to blood glucose level: normal BG group,whose BG≤7.1 mmol/L;high BG group,whose BG between 7.1 mmol/L and 11.1 mmol/L;hyperglycemia group,whose BG≥11.1 mmol/L.All patients were performed by intravenous thrombolytic treatment with rt-PA within 3 hours of symptom onset.Recanalization of infact-related coronary,complication and endpoint events were observed.Result:The percentage of recanalization of these 3 groups were 78.8%,66.0%,52.2%,respectively(P<0.05).In 30 days after thrombolytic treatment,there were no differences on bleeding.But the re-infarction,heart failure,death were significantly increased in hyperglycemia group(P<0.05)as compared to other groups.Conclusion:Increased blood glucose level could decrease the percentage of recanalization and increase the endpoint events.