急性ST段抬高型心肌梗死合并血糖代谢异常患者预后分析

目的:总结急性ST段抬高型心肌梗死(STEMI)合并血糖代谢异常(2型糖尿病或就诊血糖升高)患者的预后。方法:回顾性分析2010年1月-2013年9月我科确诊STEMI患者413例的临床资料,比较血糖正常组(A组)与就诊血糖升高组(B组)、2型糖尿病组(C组)的预后。结果:(B+C)组住院期间死亡率明显高于A组(24.7%vs.9.4%,P0.05),C组住院期间再发心肌梗死率明显高于B组和A组(3.9%vs.0%vs.0.7%,P0.05),C组、B组与A组比较,再发心绞痛率(23.4%vs.31.0%vs.14.7%,P0.05)、住院期间心力衰竭率(41.6%vs.50.0%vs.22.1%,P0.05)、住院期间MACE(58.4%vs.65.5%vs.33.4%,P0.05)及一年全因死亡率(34.2%vs.31.4%vs.16.7%,P0.05)发生率更高。结论 :STEMI合并血糖代谢异常的预后差于血糖正常组。

The Study of Prognosis in Patients with Acute ST Segment Elevation Myocardial Infarction and Abnormal Glucose Metabolism

Objective：To summarize the prognosis in patients with acute ST elevation myocardial infarction （STEMI） and high glucose or type 2 diabetes. Method： The clinical data of 413 patients with STEMI from Jan 2010 to Sep 2013 were divided into normal glucose group （group A）, high glucose group （group B） and type 2 diabetes group （group C）. The prognosis among the three groups was analyzed. Results： The in-hospital mortality in group C and group B was significantly higher than that in group A （24.7% vs.9.4% ,P〈0.05）.The in-hospital re-infarction rate in group C was significantly higher than that in group B and group A （3.9% vs. 0.7% vs. 0%,P〈0.05）. Recurrent angina rate （23.4% vs.31.0% vs.14.7%,P〈0.05）,in-hospital heart failure rate （41.6% vs. 50.0% vs. 22.1%,P〈0.05）, in-hospitalmajor adverse cardiovascular events （MACE） rate （ 58.4% vs. 65.5% vs. 33.4%,P〈0.05）and one year all cause mortality were higher （34.2% vs. 31.4% vs. 16.7%,P〈0.05）in group C and group B were significantly higher than those in group A. Conclusion： Comparing with the patients with STEMI accompanying normal glucose, the prognosis of abnormal glucose metabolism were worse.