老年2型糖尿病并发急性心肌梗死58例临床分析

目的 探讨老年2型糖尿病(T2DM)并发急性心肌梗死(AMI)的临床特点及预后的影响因素.方法 对60岁以上58例老年2型糖尿病患者并发急性心肌梗死(DM-AMI)与40例非糖尿病急性心肌梗死(NDM-AMI)患者进行临床分析,比较两组临床特点,探讨其对预后的影响因素.结果 T2DM并发急性心肌梗死的主要临床特点为胸闷、心悸、倦怠乏力、呼吸困难、心律失常、心力衰竭、心源性休克及恶心、呕吐、出汗,12例患者低血糖后并发急性心肌梗死.糖尿病组急性心肌梗死静息状态发病率高,无痛性居多,血脂紊乱多为混合型,多支病变发生率高,且严重心脏事件的总发生率均显著高于对照组.结论 积极控制血糖,预防低血糖,老年2型DM患者合并AMI预后差,病死率高.糖尿病是心肌梗死的主要危险因素,心肌梗死是糖尿病的重要死亡原因.应高度重视并积极的处理.

The clinical analysis of elderly type 2 diabetes 58 cases complicated with acute myocardial infarction

Objective To discuss clinical features and prognostic factors of elderly type 2 diabetes（T2DM） patients complicated with acute myocardial infarction（AMI）.Methods Over 60 years old in 58 elderly patients with type 2 diabetes mellitus complicated with acute myocardial infarction（DM-AMI） and 40 patients with non diabetic acute myocardial infarction（NON-AMI） were clinically analyzed,compared two groups of clinical characteristics,and to investigate the factor of prognosis.Results The main clinical features of T2DM complicated with acute myocardial infarction were chest tightness,palpitations,fatigue,dyspnea,arrhythmias,heart failure,cardiogenic shock and nausea,vomiting,sweating.12 low blood sugar patients occurred acute myocardial infarction.Acute myocardial infarction in diabetic group resting state high incidence,painless majority,dyspidemia was mixed,multivessel disease incidence rate was high,and the total incidence of serious cardiac events were significantly higher than those of control group.Conclusion Positive control of blood sugar,preventing low blood sugar.Older DM patients with AMI is poor prognosis and high mortality.Diabetes is a major risk factor for myocardial infarction,AMI is a major cause of death.We should attach importance to and actively deal with.