急性心肌梗死患者行急诊经皮冠状动脉介入术后ST段回落与高血糖的关系  

Relation between ST-segment reduction and hyperglycemia in patients with acute myocardial infarction treated with emergent PCI

作　　者：徐援[1] 常宇锋[2] 杨中苏[2] 闫慧[2] 王攀[2] 杨新春[2] 

机构地区：[1]首都医科大学附属北京朝阳医院内分泌科,北京100020 [2]首都医科大学附属北京朝阳医院心内科,北京100020

出　　处：《中国介入心脏病学杂志》2004年第6期335-337,共3页Chinese Journal of Interventional Cardiology

摘　　要：目的　探讨急性心肌梗死 (AMI)患者行急诊经皮冠状动脉介入术 (PCI)后ST段回落与血糖的关系。方法　入选AMI患者 80例 ,急诊入院后 90min内行冠状动脉造影示梗死相关血管前向血流TIMI 0到 1级 ,PCI后梗死相关血管前向血流TIMI恢复到 3级。术前常规心电图、生化与cTnI检查及抗栓治疗。术后 0 5h行心电图检查 ,1周后复查心电图。按血糖水平分为两组 :血糖 <8 8mmol/L(16 0mg/dl)为Ⅰ组 (41例 ) ,血糖≥ 8 8mmol/L(16 0mg/dl)为Ⅱ组 (39例 )。比较两组术前、术后及 1周时各导联ST段抬高的平均值及术前、术后ST段回落程度 ,并对其进行统计学分析。结果　Ⅱ组与Ⅰ组相比 ,术后及 1周时各导联抬高的ST段平均值及术前、术后ST段回落程度差异有显著性 ,患者既往是否有糖尿病其差异也有显著性。结论　急性心肌梗死再灌注治疗后心电图抬高的ST段回落程度受高血糖的影响。高血糖可能通过激活炎症及凝血系统 ,影响心肌的微循环灌注。Objective To evaluate the relation between ST segment reduction and blood glucose level in patients with acute myocardial infarction treated with emergent percutaneous coronary intervention (PCI) Methods Eighty patients with acute myocardial infarction who underwent coronary arteriography within 90 minutes after emergent hospitalization were enrolled The blood flow of Infarction related artery was Thrombolysis In Myocardial Infarction (TIMI) grades 0 to 1 and recovered to TIMI grade 3 after PCI Electrocardiogram (ECG), blood constituent, cTnI and anti thrombus therapy were routinely performed before emergency PCI ECG was reviewed in half an hour and one week the operation respectively The eighty patients were divided into 2 groups according to the blood glucose level : group 1 ( n =41) with blood glucose <160 mg/dl and group 2 ( n =39) with blood glucose ≥160 mg/dl The average ST segment elevation and reduction between the two groups before and after emergency PCI and after one week were analyzed by statistics Results The average ST Segment reductions after PCI and after one week were much higher in group 2 compared with those in group 1 (1 58±1 01 vs 0 81±0 73, 1 12±0 78 vs 0 45±0 75 mV respectively, P <0 000?1) The ST segment reductions before and after PCI in group 2 were much lower compared with group 1 (34 54%±22 56% vs 57 37%±27 03%, P < 0 000?1 ) Conclusion The microcirculation reperfusion in myocardium and ST segment reduction in patients with acute myocardial infarction are affected negatively by hyperglycemia or diabetes mellitus

关 键 词：ST段 术后 患者 高血糖 心电图 术前 急诊 经皮冠状动脉介入术 急性心肌梗死 血流 

分 类 号：R542.22[医药卫生—心血管疾病] R541[医药卫生—内科学]