老年急性心肌梗死并发糖尿病患者急诊介入治疗近期疗效

目的探讨老年急性心肌梗死（AMI）并发糖尿病患者急诊经皮冠状动脉介入治疗（PCI）的安全性。方法将316例老年（≥60岁）AMI患者分为糖尿病组（DM组，76例）和非糖尿病组（ND组，240例），于发病12h内行急诊PCI，比较两组患者临床和冠状动脉造影特征、PCI成功率及术后并发症发生率。结果（1）DM组患者血脂异常、空腹血糖水平、前壁AMI百分比均显著高于ND组分别为42．1％和24．2％，（10±3）mmol／L和（5±2．1）mmol／L，68．4％和49．6％，P〈0．05]。（2）DM组患者的梗死相关血管为前降支者显著高于ND组（60．5％和42．1％，P〈0．05），DM组三支病变、弥漫病变率显著高于ND组（78．9％和46．3％，67．1％和46．3％，P〈0．01）。（3）PCI即刻成功率、术中无复流发生率、住院期间PCI术后并发症发生率和病死率两组比较差异均无统计学意义。结论急诊PCI治疗老年AMI并发糖尿病患者近期安全有效。

In-hospital effect of primary percutaneous corollary intervention on aged patients with acute myocardial Infarction and diabetes mellitus

Objective To explore the characters of female diabetic with ST-elevation myocardial infarction （STEMI） undergoing primary percutaneous transluminal coronary angioplasty in clinical presentation,procedural success, and in-hospital outcomes.Methods The clinical data of 316 patients aged≥60 with AMI hospitalized from October 2003 to November 2006,who underwent emergency PC1 within 12 hours after the onset.including 76 cases complicated with diabetes mellitus （Group DM）and 240 cases without diabetes （non-diabetes mellitus group,Group ND） ,were analyzed respectively. Results （1）There were significant differences in dislipimia,the level blood glucose, the percentages of anterior wall AMI rate.Group DM were significantly higher than those of Group ND 42.1% vs 24.2%, （10±3）mmol/L vs （5±2.1）mmol/L,68.4% vs 49.6%,P〈0.05 ]. （2）In group DM,the infarction related artery was left anterior descending branch,which significantly higher than that of the group ND （60.5% vs 42.1%,P〈0.05）. The rates of triple vessel disease and suffusion lesion in Group DM were significantly higher than those of the Group ND （78.9% vs 46.3%,67.1% vs 46.3%,P〈0.01）. （3）There were no significant differences in the PCI immediate success rate,intra-operational no-reflow rate,post-PCI complication rate and mortality during hospitalization between the two groups.Conclusion Emergency in hospital PCI is effective on aged patients with AMI and diabetes mellitus.