急性心肌梗死急诊冠脉介入治疗近期预后与血糖异常相关性研究  

The study of abnormal glucose and short term prognosis of emergency percutaneous coronary intervention for acute myocardial infarction

作　　者：杨茂[1] 张瑞宏[2] 

机构地区：[1]哈尔滨医科大学第四临床医院心内科,黑龙江省哈尔滨150001 [2]哈尔滨医科大学第一临床医院心内科

出　　处：《中国基层医药》2007年第9期1420-1421,共2页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨应激性血糖增高对急诊冠脉介入治疗(PCI)的ST段抬高型急性心肌梗死(AMI)近期预后的影响。方法将急诊行PCI治疗的ST段抬高型AMI患者410例依据糖尿病病史及入院随机血糖水平随机分为四组:组1(n=288):随机血糖正常的非糖尿病患者;组2(n=30):随机血糖正常的糖尿病患者;组3(n=54):随机血糖增高的非糖尿病患者;组4(n=38):随机血糖增高的糖尿病患者。比较各组患者的年龄、性别、入院24h内随机血糖、糖化血红蛋白(HbA1c)、心肌酶峰值、TIMI血流恢复情况及30d病死率。结果四组住院病死率分别为4.2%、3.4%、7.5%、5.9%(P<0.01)。入院随机血糖增高的糖尿病组及非糖尿病组急诊PCI术后30d病死率高于随机血糖正常组,其中随机血糖增高的非糖尿病组30d病死率高于糖尿病组。结论应激性血糖增高是影响ST段抬高型AMI急诊PCI疗效的重要指标之一,与近期预后密切相关。Objective To investigate the recent prognosis of stress hyperglycemia for the emergency percutaneous coronary intervention（PCI） with ST-segment elevation acute myocardial infarction（AMI）. Methods 410 patients treated by emergency PCI were chosen. According to a history of diabetes and blood glucose levels,they were randomly divided into four groups：group 1（ n = 288）：random blood glucose normal and non-diabetic patients;group 2（ n =30） ：random normal blood glucose in diabetic patients;group 3（ n = 54） ：random plasma glucose level and nondiabetic patients;group 4 （ n = 38） ：high random plasma glucose level in diabetic patients. Age, gender, hospital within 24 hours with random glucose,glycated hemoglobin（HbAlc） ,peak creatine kinase, TIMI flow recovery and 30-day mortality of the patients were compared. Results Mortality of four groups were 4.2 % .3.4 %, 7.5 % and 5.9 % respectively（ P 〈 0.01）. Plasma glucose level in diabetic and non-diabetic group after PCI and 30-day inortality were higher than those of normal blood sugar team. 30-day mortality rate of non-diabetic group in wh]6h blood glucose randomly increased was higher than that of the diabetic group. Conclusions Stressed hyperglycemia would influence the ST-segment elevation AMI PCI efficacy and was one of the important indicators, which was closely related with the short-term prognosis.

关 键 词：心肌梗死 血管形成术 经腔 经皮冠状动脉 血糖 预后 

分 类 号：R542.22[医药卫生—心血管疾病]