糖尿病和肾功能与急性心肌梗死患者预后的相关性分析

目的评估急性心肌梗死（AMI）后存活的高危患者，其肾功能和是否存在糖尿病（DM）与预后的相关性。方法连续入选2002年6月～2007年6月我院CCU收治的急性心肌梗死（AMI）患者，记录血清肌酐的基线数值，并按照有无糖尿病分成两组，组内根据肾小球滤过率（eGFR）的高低分成亚组。平均随访24．7个月。主要终点是全因死亡，次要终点为再发心血管事件。结果DM组随着eGFR的降低，校正后的临床事件的风险逐渐增加（P〈0．001）；非DM组也有相似的结果。结论多因素Cox回归分析显示，糖尿病是全因死亡率和再发心血管事件联合终点的独立危险因素，而对于再发心血管事件联合终点DM与eGFR之间没有相互作用。

The Relationship between Renal Function and Prognosis Following Acute Myocardial Infarction in Patients With and Without Diabetes Mellitus

Objective To evaluate the acute myocardial infarction （AMI）, survival after high-risk patients, their renal function and the existence of diabetes mellitus （DM） and the prognosis. Method selected a row in June 2002~June 2007 admitted to our hospital CCU with acute myocardial infarction （AMI） patients with recorded baseline serum creatinine values, and in accordance with whether diabetes divided into two groups according to glomerular filtration rate in group （eGFR） were divided into high and low subgroups. The average follow-up of 24.7 months. The primary endpoint was all-cause death, the secondary endpoint of recurrent cardiovascular events. Results DM group with eGFR lower, after correction for gradually increasing the risk of clinical events （P〈0.001）; the non-DM group also had similar results. Conclusion Multivariate Cox regression analysis showed that diabetes is all-cause mortality and combined endpoint of recurrent cardiovascular events in an independent risk factor for recurrent cardiovascular events and for joint end there is no interaction between DM and eGFR.