摘要
目的探讨入院即刻血糖水平对老年急性心肌梗死(AM I)患者行经皮冠状动脉介入(PCI)治疗后住院死亡率的预测价值。方法选择作者所在医院行急诊PCI治疗的非糖尿病急性心肌梗死患者120例。其中,男性98例,女性22例。年龄60～82岁,平均年龄68.1岁±4.3岁。按入院即刻血糖(SG)水平分为3组:SG≥6.1mmol/L为A组(强化治疗组)44例,SG≥11.1mmol/L为B组(常规治疗组)31例,血糖正常为C组45例,分别对3组患者住院期间心力衰竭、恶性心律失常、再梗死、梗死后心绞痛及主要不良心脏事件(MACE)的发生率进行对比分析。结果在心脏性死亡、急性心力衰竭、再梗死、梗死后心绞痛、恶性心律失常等方面,3组之间差异有统计学意义(P<0.05);B组并发症的发生率明显高于A、C组;而A、C组未显示差异有统计学意义;MACE发生率分别为C组8.9%,B组38.6%,A组29.0%,3组之间差异均有统计学意义(P<0.001)。结论入院即刻血糖升高的急性心肌梗死患者实施急诊PCI治疗后,院内死亡率及总的心血管事件发生率高,应给予重视。
Objective To study the predictive value immediate serum glucose（SG） level on admission hospitalized mortality in old patients with acute myocardial infarction（AMI） after emergency percutaneous coronary intervention（PCI）.Methods A total of 120 non-diabetics AMI patients after PCI,male 98,female 22,aged 60～82 years,mean aged 68.1±4.3 years,were divided into 3 groups according to SG levels on admission.Group A,SG≥6.1 mmol/L,n=44;Group B,SG≥11.1 mmol/L,n=31;Group C,3.9SG6.1 mmol/L,n=45.The incidence of cardiac failure,arrhythmia,cardiac death,re-infarction,post-infarction angina pectoris and major adverse cardiac events（MACE） among 3 groups were compared.Results The incidence of bad prognostic events,such as asymptomatic myocardial infarction,arrhythmia cardiogenic shock and heart failure were increased in patients with stress hyperglycemia（SHG） compared with AMI cases.Moreover,the incidence of bad prognostic events were lower in well-controlled group than in poorly controlled group and the value was also statistically significance.The incidence of worse prognostic events were higher in group A and B than that in group C（P0.05）;Incidence of MACE was significantly higher in group B,compared with group A and C,29.0% vs 38.6% vs 8.9% in MACE（P0.001）.Conclusion It is demonstrated that there is higher hospitalized mortality and occurrence rate of total cardiovascular events in AMI patients with elevated immediate admission SHG level after treated by emergency PCI.Thus the immediate admission hyperglycemia in AMI patients may predict poor prognosis.
出处
《黑龙江医学》
2010年第8期570-572,共3页
Heilongjiang Medical Journal
关键词
经皮冠状动脉腔内成形术
应激性高血糖
急性心肌梗死
Acute myocardial infarction
Percutaneous coronary intervention
Stress-induced hyperglycaemia
