急性心肌梗死在2型糖尿病与非糖尿病中的临床对比研究

目的了解2型糖尿病并发急性心肌梗死的临床特点及预后。方法对255例糖尿病并急性心肌梗死和200例非糖尿病急性心肌梗死做临床对比研究。结果发现2型糖尿病发生无痛性急性心肌梗死的构成比(36.47%)较非糖尿病者发生的构成比(10.5%)高(P<0.005);发生大面积梗死的构成比(32.94%)比对照组的发生构成比(15.5%)明显升高(P<0.005);严重心律失常的发生构成比(60.39%)及死亡构成比(22.35%)均明显高于非糖尿病者(39%、9%)(P<0.025和0.005),主要死因均为泵衰竭和心跳骤停;入院第一周内的死亡构成比(13.73%)较非糖尿病者(4%)明显升高(P<0.005)。结论2型糖尿病并发急性心肌梗死患者较无糖尿病的急性心肌梗死患者病情重、预后差、第一周内及住院期的死亡率高。

Clinical Study for Acute Myocardial Infarction in Patients with T2DM and Without Diabetes Mellitus

Objectives To analysis the clinical characteristic and prognosis of T2DM with complication of acute myocardial infarction.Methods 255 T2DM patients with complication of acute myocardial infarction,and 200 non-diabetes patients with acute myocardial infarction were studied.Results The ratio of T2DM patients have no-pain acute myocardial infarction is 36.47%,which is higher than that of the patients without diabetes mellitus(10.5%,P<0.005).The ratio of having large-area infarction in T2DM patients is much higher than the control group(32.94% vs 15.5%,P<0.005).The ratios of having severe arrhythmia(60.39%) and mortality(22.35%) in the T2DM patients are both higher than those in patients without diabetes mellitus(39% and 9%,P<0.025 and P<0.005,respectively).The main causes of death are both pump failure and sudden cardiac arrest.The mortality in the first week of hospitalization is higher in the T2DM patients than the patients without diabetes mellitus(13.73% vs 4%,P<0.005).Conclusion The T2DM patients with complication of acute myocardial infarction have more severe state,worsen prognosis,and higher mortality in the first week of hospitalization than those patients without diabetes mellitus.