摘要
目的探讨糖尿病（DM）心肌梗死（AMI）患者急性期血糖变化及对心功能的影响。方法将73例AMI患者根据有无DM分为DM组（35例）和非DM组（38例），比较两组血糖变化特点及其与心功能的相关性。结果DM组有33例（94．29％，33／35）空腹血糖升高，非DM组有14例（36．84％，14／38）应激性高血糖。DM组空腹血糖和糖化血红蛋白分别为（9．7±2．4）mmol／L、（10．13±1．95）％，均明显高于非DM组的（5．8±2．3）mmol／L、（7．22±1．87）％，差异有统计学意义（P〈0．05）；DM组肌酸激酶同工酶MB（CK-MB）和肌钙蛋白T（TnT）分别为（217±53）U／L、（6．2±3．7）mg／L，明显高于非DM组的（119±47）U／L、（3．4±2．9）mg／L，差异有统计学意义（JP〈0．05）。AMI后4周左心功能指标检测显示，DM组左室舒张末期容量（EDV）、左室收缩末期容量（ESV）分别为（81．7±10．8）、（47．6±10．7）ml，明显高于非DM组的（74．9±10．2）、（39．8±12．6）ml，而左室射血分数（LVEF）为（41．7±4．8）％，明显低于非DM组的（48．9±8．5）％，差异有统计学意义（P〈0．05）。结论AMI合并DM患者急性期多伴有应激性血糖升高，心功能差，应积极进行干预。
Objective To explore the blood glucose changes in diabetes mellitus （DM） patients with acute myocardial infarction（AMI） and its influence on heart function. Methods Seventy-three patients with AMI were divided into DM group （35 cases） with DM and non-DM group （38 cases） without DM. The blood glucose changes and the relationships with heart function were observed in two groups. Results In DM group,33 cases （94.29% ,33/35） had high fasting blood glucose,whereas in the non-DM group, 14 cases （36.84%, 14/38） had stress hyperglycemia. The levels of fasting blood glucose and glycosylated hemoglobin in the DM group were significantly higher than those in the non-DM group [ （9.7 ± 2.4） mmol/L vs. （5.8 ±2.3） rnmol/L, （10.13 ± 1.95）% vs. （7.22 ± 1.87）% ,P 〈0.05]. The levels of creatine kinase isozyme MB （CK-MB） and troponin T （TnT） in the DM group were significantly higher than those in the non-DM group [ （ 217 ± 53 ） U/L vs. （ 119 ± 47 ） U/L, （6.2 ± 3.7 ） mg/L vs. （3.4 ± 2.9） mg/L, P 〈 0.05 ]. The detection of left ventricular function after 4 weeks of AMI showed that left ventricular end diastolic volume （EDV） and end systolic volume （ESV） of the DM group were significantly higher and LVEF was significantly lower than those of the non-DM group [ （81.7 ±10.8 ） ml vs. （74.9 ± 10.2） ml, （47.6 ± 10.7） ml vs. （39.8 ± 12.6 ） ml, （41.7 ± 4.8 ）% vs. （48.9 ±8.5 ）%, P 〈 0.05 ]. Conclusions Patients with AMI and DM have high hyperglycemia and worse heart function. Therefore, intervention measures should be performed for these patients.
出处
《中国医师进修杂志》
2012年第16期20-22,共3页
Chinese Journal of Postgraduates of Medicine
关键词
心肌梗死
糖尿病
血糖
Myocardial infarction
Diabetes mellitus
Blood glucose
