糖尿病急性心肌梗死早期病死率性别差异的探讨

目的 探讨性别对糖尿病急性心肌梗死(AMI)早期病死率的影响及其原因。资料与方法 分析181例AMI:男95例,年龄(67.86±11.18)岁,其中糖尿病50例;女86例,年龄(75.08±6.78)岁,其中糖尿病46例。对男女患者住院30d病死率、年龄、血糖、血脂、从症状出现至就诊时间、溶栓及介入治疗进行比较。结果 女性AMI病死率高于男性(27.91％vs 12.63％),糖尿病AMI病死率高于非糖尿病(25.00％vs 14.12％),糖尿病AMI女性病死率高于男性(36.96％vs 14.00％),女性糖尿病AMI年龄较大,空腹血糖、甘油三酯高于男性,出现症状至入院时间较长,溶栓治疗与介入治疗较少,以上因素进行多因素回归分析发现性别、出现症状至入院时间与糖尿病急性心肌梗死早期病死率有关。结论 女性急性心肌梗死病死率高于男性,尤其是糖尿病急性心肌梗死。

Gender differences in the early mortality of AMI patients with diabetes

Objectives To investigate whether gender plays a role and why, in the context of early mortality in AMI patients with diabetes. Methods A cohort of 181 AMI patients (male 95, age 67 + 11, female 86, age 75 + 6) were analysed. Of the 95 males, 50 were diabetic, as to the 86 females, 46 were such. The mortality rate witinn the 30 days hospitalization was accounted for, using age, blood sugar, blood lipid profile, onset of symptoms to admission time, throm-bolytic treatment and/or angioplasty as variables for comparison between male and female AMI patients. Results Mortality was ingher in female AMI patients than in male (27.91% vs 12.63%). The mortality rate in diabetic AMI and non-diabetic AMI was25.00% vs 14.12%. When diabetes was taken into account, it was 36.96% in females i, 14.00% in males. Female diabetic patients with AMI were older, fasting blood glucose, triglyceride were ingher in females , onset of symptoms to admission was longer and less thrombolytic treatment and/or angioplasty were undertaken in females. The above differences were all statistically significant. After Cox Muti-variant logistic regression analysis of the variables, it was found that gender and time to admission were related with early mortality in AMI patients with diabetes. Conclusions Mortality in female AMI patients is ingher than in males. It is more in diabetic females with AMI.