急性心肌梗死患者空腹血糖水平与近期心血管事件的相关性研究

目的探讨急性心肌梗死患者入院时空腹血糖水平与急性期临床心血管事件发生率之间的关系,为临床实践提供理论依据。方法选取2005年1月至2007年12月急性心肌梗死发病24h之内入本院的138例患者为研究对象,根据入院后第2天空腹血糖水平和既往有无糖尿病史分为2组：糖代谢正常组：血糖≤6.0mmol/L;糖代谢异常组：血糖〉6.0mmol/L或既往确诊糖尿病者,比较2组患者一般临床资料和住院期间心血管事件（充血性心力衰竭、严重心律失常、心源性休克、心源性死亡）的发生情况。结果糖代谢异常组严重心律失常、充血性心衰、心源性休克的发生率显著高于糖代谢正常组（P〈0.05）,心源性死亡两组之间没有统计学意义。结论糖代谢异常的急性心肌梗死患者急性期心血管事件的发生率显著增高;空腹血糖水平是急性心肌梗死患者近期充血性心衰、心源性死亡的主要影响因素;心功能（Killip分级）是急性心肌梗死患者近期心源性休克、严重心律失常。心源性死亡的主要影响因素。

Research of the relationship between fasting glucose and cardiovascular events with acute myocardial infarction

Objective To investigate the relationship between fasting glucose and cardiovascular events with acute myocardial infarction. Methods 138 patients with acute myocardial infarction were enrolled in the study from January 2005 to December 2007 ,who were divided into two groups according to fasting glucose in the next day：normal glucose metabolism group, fasting glucose ~〈6. 0 mmol/L; abnormal glucose metabolism group, fasting glucose 〉 6. 0 mmol/L or previously diagnosed diabetes mellitus. Record the cardiovascular events of the two groups in hospital（ congestive heart failure, severe arrhythmias, cardiogenic shock, cardiac death）. Results The following morbidity of cardiovascular events in abnormal glucose metabolism group than those in normal glu- cose metabolism group ： severe arrhythmias, congestive heart failure, cardiogenic shock. There were no significant differences between the groups in morbidity of cardiac death. Conclusion This study showed the patients with abnormal glucose metabolism had a high morbidity of cardiovascular events in short term ; Fasting glucose was an important influence factor in congestive heart failure and cardiac death in short term; Heart function was an im- portant influence factor in cardiogenic shock, severe arrhythmias and cardiac death in short term.