梗死前心绞痛对合并糖尿病的急性心肌梗死患者左心室功能的影响

目的　探讨梗死前心绞痛对合并糖尿病的急性心肌梗死 (AMI)患者左心室功能的近期影响。方法　首次AMI并行急诊PCI患者 15 6例 ,在糖尿病和非糖尿病患者中分别比较有梗死前心绞痛和无梗死前心绞痛组血清肌酸激酶MB(CKMB)峰值和左心室功能的变化。结果　非糖尿病患者中有梗死前心绞痛组血清CKMB峰值低于 ,左室EF高于无梗死前心绞痛组 (CKMB :10 8± 79IU/Lvs 15 6± 10 1IU/L ;EF∶5 8± 13%vs 5 0±11% ,P <0. 0 5 ;糖尿病患者中有梗死前心绞痛组和无梗死前心绞痛组血清CKMB峰值和左心室EF无显著性差异。结论　梗死前心绞痛可在非糖尿病合并AMI患者中限制梗死面积 ,保护左心功能 ,而在糖尿病合并AMI患者中无保护作用。

Effects of Prodromal Angina Pectoris on Left Ventricular Function in Diabetic Patients with Acute Myocardial Infarction

Objective To evaluate the effects of prodromal angina pectoris on left ventricular function in diabetic patients with acute myocardial infarction (AMI). Methods In 156 patients with first AMI, serum creatine kinase MB (CKMB) and LVFE were compared between group with prodromal angina and group without prodromal angina in patients with or without diabetes. Results In patients wothout diabetes, compared with the group without prodromal angina, CKMB peak was lower (108±79 IU/L vs 156±101 IU/L, P<0 05) and LVEF was higher (58±13% vs 50±11%, P<0 05) in the group with prodromal. However, in patients with diabetes, there was no significant difference in peak CKMB and LVEF between the groups with or without prodromal angina. Conclusions prodromal angina pectoris can limit infarction area, protect left ventricular function in non-diabetic patients with AMI. However, such beneficial effects or prodromal angina pectoris were not observed in diabetic patients.