糖尿病对老年非ST段抬高型心肌梗死患者冠状动脉介入治疗后左心室重塑及短期预后的影响  

The influence of diabetes mellitus on left ventricular remodeling and short-term prognosis after primary percutaneous coronary inter- vention in elderly patients with acute non- ST segment elevation myocardial infarction

作　　者：王海斌 薛军[2] 高晓丽 王玉霞 张小坤 崔慎情 WANG Hai-bin XUE Jun GAO Xiao-li WANG Yu-xia ZHANG Xiao-kun CUI Shen-qing(Department of Cardiology, General Hospital of Huabei Oil field, Renqiu, Hebei, 062552, Chin)

机构地区：[1]华北石油总医院心内科,任丘062552 [2]北京煤炭总医院心脏中心

出　　处：《中国急救复苏与灾害医学杂志》2017年第1期27-30,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：中石油华北油田公司重大科研项目（编号：2016-HB-G0402）

摘　　要：目的探讨糖尿病对老年非ST段抬高型心肌梗死（NSTEMI）患者择期PCI后左心室重塑及短期预后的影响。方法入选92例糖尿病患者，364例非糖尿病患者。比较两组一般临床情况、造影和介入治疗结果、入院和6个月时超声心动图所示左心室重塑情况、随访期间不良心脏事件发生率。结果糖尿病组患者的高脂血症比例、贫血比例、多支血管病变比例高于非糖尿病组，差异均有统计学意义（均P〈0．05），住院期间应用B阻滞剂治疗比例明显降低（P〈0．05）。PCI后6个月糖尿病组患者左心室重塑比例明显升高（P=0．02）。6个月内糖尿病组因心力衰竭再次入院率明显高于非糖尿病组（P〈0．05）。结论老年非ST段抬高型心肌梗死患者行冠状动脉介入治疗后，糖尿病患者更易发生左心室重塑，且增加心血管事件的风险。Objective To investigate the influence of diabetes mellitus （DM） on left ventricular（LV） remodeling and short-term prognosis in elderly patients with acute non ST-segment elevation myocardial infarction （NSTEMI） treated by selective percutaneous coronary intervention （PCI） . Methods A total of 508 gerontal patients were recruited with NSTEMI gived PCI from January 2012 to June 2015 in the General Hospital of Huabei Oil field.. According to the medical history and blood sugar tested after admission, they were divided into diabetic and non-diabetic group. Baseline, angiographic and PCI features and prevalence of LV remodeling were compared between the two groups of patients during hospitalization and 6-month clinical follow-up. Results Finally, 92 diabetic and 364 non-diabetic patients completed the study. Compared with the non-diabetic group, there were a significantly higher proportion of patients with hyperlipemia, anemia and multivessel disorders （P 〈0.05）, the proportion of using beta blockers was obviously lower during hospitalization （P 〈 0.05）. More patients in diabetic group had LV remodeling 6-month clinical follow-up （P 〈0.05）. The proportion of patients with heart failure was significantly higher in diabetic group（P 〈 0.05）. Conclusions In elderly patients with acute non- ST ＂segment elevation myocardial infarction after coronary artery intervention treatment, patients with diabetes were more likely to have left ventricular remodeling and increaing risk of cardiovascular events.

关 键 词：心肌梗死 经皮冠状动脉介入治疗 左心室重塑 糖尿病 

分 类 号：R541.4[医药卫生—心血管疾病]