老年2型糖尿病并发无痛性急性心肌梗死35例临床分析

目的探讨老年2型糖尿病（T2DM）并发无痛性急性心肌梗死（PAMI）的临床特点。方法回顾性分析35例老年2型糖尿病并发急性心肌梗死患者的临床资料（T2DM组），35例老年非糖尿病急性心肌梗死患者作为对照组（NT2DM组）。分析老年2型糖尿病并发无痛性急性心肌梗死的主要临床表现及心电图特点。结果老年2型糖尿病易并发无痛性急性心肌梗死，主要临床表现为牙痛、恶心呕吐、心力衰竭、心源性休克，心电图易出现室性心律失常、sT段不明显抬高，其并发症多、病死率高，与对照组相比差异具有统计学意义（P〈0．05）。结论应提高对老年2型糖尿病并发无痛性急性心肌梗死的认识，积极控制糖尿病，及时确诊无痛性急性心肌梗死可明显改善患者的预后。

Clinical study on painless acute myocardial infarction in 35 cases of gerontic type 2 diabetes mellitus

Objective To investigate the clinical features of painless acute myocardial infarction （PAMI） in patients with gerontic type 2 diabetes mellitus. Methods 35 cases of painless AMI with type 2 diabetes mellitus were ana- lyzed retrospectively, with another 35 cases of AMI with non - type 2 diabetes mellitus as the control group to investigate the main clinical manifestations and ECG features of AMI with gerontic type 2 diabetes mellitus. Results Type 2 diabe- tes mellitus of gerontism is often subjected to PAMI, with the main features such as toothache, nausea and vomiting, heart failure, cardiogenic shock, ventricular arrhythmia, AMI with low elevation in ST segment in electrocardiogram. Its multiple complications and high mortality had significant statistical differences compared with the control group （P 〈 0.05 ）. Conclusion It is important to raise the awareness of gerontic type 2 diabetes mellitus with painless AMI and control the progression of diabetes mellitus. Timely diagnosis of PAMI can significantly improve the prognosis.