糖尿病并发急性心肌梗死溶栓治疗病例临床分析

目的探讨糖尿病（DM）患者发生急性心肌梗死（AMI）的临床特点、促发因素、疗效和转归。方法回顾性对比分析我院住院的2005年1月到2008年12月186例急性心肌梗死病人溶栓治疗资料分析。对糖尿病发生急性心肌梗死组（A组，89例）与非糖尿病发生急性心肌梗死组（B组，97例）的发病时状态，临床特点及相关检查资料进行对照研究，比较两组急性心肌梗死有无不同。结果与B组比较，A组发病年龄早，安静状态下起病多，无痛性急性心肌梗死多，病变部位较弥散，血甘油三酯高，严重并发症及心力衰竭发生率高，溶栓治疗再灌注率低，死亡率高。P〈0．01及0．05；其促发因素集中在过度饮食、失眠、情绪激动、过度劳累及停用药物。结论糖尿病患者发生急性心肌梗死发病年龄早，起病不典型，病变部位多，常呈无痛型，严重心脏并发症多，溶栓疗法再灌注率低，住院病死率高，预后差。

Effect of thrombolytic therapy on diabetic patients complicated with acute myocardial infarction

Objective To investigate the clinical features, risk factors, therapeutic effect and prognosis. Methods The 186 inpatients with acute myocardial infarction from January 2005 to December 2008 were divided into diabetic acute myocardial infarction group （Group A） consisted of 89 cases and non diabetic acute myocardial infarction group （Group B） consisted of 97 cases and retrospectively analyzed . Results In comparison with Group B the age of the patients in Group A was younger and had an onset under quient state and most of them had a non-painful acute myocardial infarction with infusion loci. The level of triglyceride arised with high incidence of complications and heart failure. The rates of thromhlytie therapy and lavage were low and the mortality was high, showing significant differences between the two groups（P〈0.05 or P〈 0.01）. The risk factors were overeating, INSOMNIA, agitation, overworking or intrrupting use of drugs. Conclusion The clinical features of diabetic acute myocardialo infearetion patients are diversous with severe complications, high mortality and poor prognosis.