摘要
目的探讨入院时血糖水平与接受直接冠状动脉介入术治疗的急性前壁心肌梗死(acute myocardial infarction,AMI)患者心功能的相关性。方法 362例发病时间<12h的前壁AMI患者行直接冠状动脉介入术,根据入院时血糖水平分为2组:血糖≥7.8mmol/L组(149例)与血糖<7.8mmol/L组(213例),分析2组患者临床特点及心功能。结果与血糖<7.8mmol/L组比较,血糖≥7.8mmol/L组患者高血压病史、糖尿病史、KillipⅢ及Ⅳ级、心力衰竭发生率明显升高,左室射血分数、KillipⅠ级、术后TIMI 3级血流及术后ST段回落率比率明显降低,差异有统计学意义(P<0.05);校正其他危险因素后,血糖≥7.8mmol/L是心力衰竭发生的独立影响因素(OR=1.314,95%CI:0.873～2.185,P=0.041)。结论入院时血糖水平高的前壁AMI患者心功能较差,心力衰竭发生率高。
Objective To investigate the relationship between plasma glucose and heart function in patients with acute anterior wall myocardial infarction after primary percutaneous coronary intervention（PCI）.Methods A total of 362 patients with acute anterior wall myocardial infarction underwent primary PCI within 12 hours after onset time,and were divided into two groups according to the plasma glucose,plasma glucose≥7.8 mmol/L group（n=149） and plasma glucose 7.8 mmol/L group（n=213）.The clinical characteristics and heart function were analyzed and compared between two groups.Results Compared with the plasma glucose 7.8 mmol/L group,the history of hypertension and diabetes mellitus,Killip class Ⅲ and Ⅳ and the incidence of heart failure increased significantly,and left ventricular ejection fraction,Killip classⅠ,TIMI flow grade 3 and ST resolution after operation decreased significantly in plasma glucose ≥7.8 mmol/L group（P0.05）.Logistic analysis showed that plasma glucose ≥7.8 mmol/L was an independent factors for heart failure（OR=1.314,95%CI： 0.873 to 2.185,P=0.041）.Conclusion The patients with acute anterior wall myocardial infarction have poor heart function when plasma glucose is high at admission,and the incidence of heart failure is high.
出处
《中华实用诊断与治疗杂志》
2013年第7期654-656,共3页
Journal of Chinese Practical Diagnosis and Therapy
基金
首都医科大学基础-临床合作课题(10JL55)
关键词
急性心肌梗死
血糖
直接冠状动脉介入术
心功能
Acute myocardial infarction
blood glucose
percutaneous coronary intervention
heart function
