女性糖尿病急性心肌梗死急诊PCI特点分析  

Short-term effect of emergency PCI in female diabetes patients with acute myocardial infarction

作　　者：刘恒亮[1] 刘洋[1] 耿国英[1] 巴宁[1] 荆松宾 郭微[1] 张志芳[1] 

机构地区：[1]郑州人民医院心内科,河南省450002

出　　处：《中国心血管病研究》2014年第6期489-493,共5页Chinese Journal of Cardiovascular Research

基　　金：郑州市创新型科技人才队伍建设项目（项目编号：096SYJH331144）

摘　　要：目的探讨女性糖尿病（DM）合并急性心肌梗死（AMI）急诊经皮冠状动脉介入治疗（PCI）的近期疗效和安全性。方法选择接受急诊PCI的DM合并AMI患者169例，依据性别分为女性52例为研究组（A组），男性117例为对照组（B组），分别对两组的临床资料、冠状动脉病变特征、住院时间和并发症的发生率进行比较。结果女性组平均年龄，高脂血症病史，双支、三支及合并左主干病变显著高于男性组（P〈0．05），吸烟史、既往PCI史、梗死前心绞痛显著低于男性组（P〈0．05）。PCI术后女性组TIMI3级血流和TMPG3级显著低于男性组（P〈0．01）。女性组严重心律失常、KillipⅢ级以上心功能、心源性休克等并发症的发生率和30d病死率显著高于男性组（P〈0．05）。结论女性DM合并AMI患者PCI术后TIMI血流和TMPG低，并发症多于男性。Objective To explore the short-term efficacy and safety of emergency percutaneous coronary intervention（PCI） in the female diabetic patients complicated with acute myocardial infarction（AMI）. Methods A total of 169 diabetic patients with AMI who underwent emergency PCI were selected and divided into research （group A） and control （group B） groups, which included 52 females and 117 males, respectively. Comparison of clinical data, characteristics of coronary artery lesions, length of hospital stay and incidence of complications was performed between two groups. Results The average age, history of hyperlipidemia, double branch lesions, triple branch lesions and left main lesions were significantly higher in female group than those of male group （P〈0.05）, smoking history, PCI history, preinfarction angina were distinctly lower in female group than those of male group （P〈0.05）. Thrombolysis in myocardial infarction 3 （TIMI 3） flow and TIMI myocardial perfusion grade 3 （TMPG 3 ） after PCI were markedly lower in female group compared with those of male group（P〈0.01 ）. Female group had higher incidence of complications, such as severe airhythmia, cardiac function Killip Ⅲ- Ⅳ and cardiogenic shock, as well as 30-day mortality rate than male group （P〈0.05）. Conclusion Female diabetic patients with AMI have lower TIMI 3 flow and TMPG 3 after PCI and higher incidence of complications compared with male pa- tients.

关 键 词：糖尿病 急性心肌梗死 急诊经皮冠状动脉介入治疗 女性 

分 类 号：R542.2[医药卫生—心血管疾病]