ST段抬高的急性心肌梗死患者入院即刻随机血糖水平与预后相关性分析(1)
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[摘要] 目的 观察急性ST段抬高的心肌梗死(STEMI)患者血糖水平对其心功能、预后及1年后病死率的影响。 方法 连续入选2006年1月～2008年10月间所有符合STEMI 患者217例，根据入院后即刻随机血糖分A组(血糖<7.8mmol/L)，B组[血糖(7.8～10.9)mmol/L]，C组(血糖≥11.0mmol/L) 三组。观察心脏不良事件、心因性死亡、再次心梗、心绞痛复发情况。 结果 心功能等级随着糖代谢异常程度的增加而增加。三组血糖水平、有糖尿病史患者发生心血管不良事件比较差异有显著意义。Logistic 回归模型结果显示血糖水平是STEMI患者心脏事件发生、死亡、心绞痛复发的危险因素(P < 0.05)。结论 伴高血糖的急性ST段抬高心肌梗死(STEMI)患者心功能及预后较差。
[关键词] 心肌梗死；高血糖症；预后；死亡率
[中图分类号] R544.2+2 [文献标识码] B [文章编号] 1673-9701(2012)04-0064-03
Impact of admission blood glucose on prognosis of ST-segment elevation myocardial infarction
FENG Shan
Department of Cardiology, the First People’s Hospital of Zhumadian City in Henan Province , Zhumadian 463000, China
[Abstract ] Objective To investigate the impact of admission blood glucose in patients with acute ST-segment elevation myocardial infarction (STEMI ). Methods A total of 217 patients with STEMI between January 2006 and October 2008 in cardiology department were divided into 3 groups according to the levels of blood glucose on admission: group A, <7.8 mmol/L ; groupB, (7.8～10.9)mmol/L; group C, ≥11.0 mmol/L. To collect and analyze the major adverse cardiac events , the cumulative survival rates and the correlated risk factors . Results At the end of the one-year follow-up ,the incidences of major adverse cardial events, recurring angina pectoris, one-year mortality rate of group C were significantly higher than those in group A and B (P < 0.05). The logistic regression model analysis showed that the blood glucose was an independent risk factor for incidence of major adverse cardiac events ,all causse mortality and recurring angina pectoris (P < 0.05). Conclusion Hyperglycemia at admission was associated with poor cardiac function and prognosis in patients with acute STEMI.
[Key words ] Myocardial infarction; Hyperglycemia; Prognosis; Mortality
2006年“中国住院冠心病患者糖代谢异常研究”报告显示中国冠心病住院患者中约3/4合并糖代谢异常[1]，很多研究证实即使没有糖尿病史，早期也可出现血糖水平升高且和死亡等不良事件的发生有关，急性高血糖是AMI预后不良的危险因素[2]。为此本研究观察STEMI患者入院即刻血糖水平对其预后及1年后病死率影响，为临床合理治疗提供参考依据。
1 资料与方法
1.1对象
连续入选2006年1月～2008年10月所有符合STEMI入住心内科的患者217例 ......
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