中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2013年
5期
473-476
,共4页
刘挺松%陈一天%江时森%宫剑滨%张启高%彭永平%王立军%程训民%邹莺
劉挺鬆%陳一天%江時森%宮劍濱%張啟高%彭永平%王立軍%程訓民%鄒鶯
류정송%진일천%강시삼%궁검빈%장계고%팽영평%왕립군%정훈민%추앵
急性心肌梗死%糖尿病%高血糖%预后
急性心肌梗死%糖尿病%高血糖%預後
급성심기경사%당뇨병%고혈당%예후
Acute myocardial infarction%Diabetes mellitus%Hyperglycemia%Prognosis
目的 评估急性心肌梗死(AMI)早期不同糖代谢状态患者院内及近期预后的差异.方法 前瞻性对连续111例既往无糖尿病史的AMI患者进行动态血糖监测,连续跟踪患者人院后72 h血糖波动情况,根据AMI早期血糖波动情况将所有患者分为:血糖正常组(NG组),一过性血糖升高组(TH组),持续性血糖升高组(PH组),评估3组患者院内并发症发生率及近期预后的差异.结果 3组患者心肌梗死部位比较差异无统计学意义.PH组患者较NG组和TH组患者恶性心律失常[分别为10.0％(3/30)、11.1％(4/36)、31.1％ (14/45),x2=7.347,P＜0.05]、心源性休克[分别为3.3％(1/30)、5.6％(3/36)、24.4％(11/45),x2=9.686,P＜0.01]发生率显著升高,差异有统计学意义.院内[分别为0、5.6％(3/36)、15.6％ (7/45),x2=6.312,P＜0.05]、3个月后病死率[分别为0、5.6％(3/36)、17.8％(8/45),x2=7.715,P＜0.05]显著升高,差异有统计学意义.结论 AMI早期持续血糖升高的患者院内并发症发生率高,近期预后不佳.
目的 評估急性心肌梗死(AMI)早期不同糖代謝狀態患者院內及近期預後的差異.方法 前瞻性對連續111例既往無糖尿病史的AMI患者進行動態血糖鑑測,連續跟蹤患者人院後72 h血糖波動情況,根據AMI早期血糖波動情況將所有患者分為:血糖正常組(NG組),一過性血糖升高組(TH組),持續性血糖升高組(PH組),評估3組患者院內併髮癥髮生率及近期預後的差異.結果 3組患者心肌梗死部位比較差異無統計學意義.PH組患者較NG組和TH組患者噁性心律失常[分彆為10.0％(3/30)、11.1％(4/36)、31.1％ (14/45),x2=7.347,P＜0.05]、心源性休剋[分彆為3.3％(1/30)、5.6％(3/36)、24.4％(11/45),x2=9.686,P＜0.01]髮生率顯著升高,差異有統計學意義.院內[分彆為0、5.6％(3/36)、15.6％ (7/45),x2=6.312,P＜0.05]、3箇月後病死率[分彆為0、5.6％(3/36)、17.8％(8/45),x2=7.715,P＜0.05]顯著升高,差異有統計學意義.結論 AMI早期持續血糖升高的患者院內併髮癥髮生率高,近期預後不佳.
목적 평고급성심기경사(AMI)조기불동당대사상태환자원내급근기예후적차이.방법 전첨성대련속111례기왕무당뇨병사적AMI환자진행동태혈당감측,련속근종환자인원후72 h혈당파동정황,근거AMI조기혈당파동정황장소유환자분위:혈당정상조(NG조),일과성혈당승고조(TH조),지속성혈당승고조(PH조),평고3조환자원내병발증발생솔급근기예후적차이.결과 3조환자심기경사부위비교차이무통계학의의.PH조환자교NG조화TH조환자악성심률실상[분별위10.0％(3/30)、11.1％(4/36)、31.1％ (14/45),x2=7.347,P＜0.05]、심원성휴극[분별위3.3％(1/30)、5.6％(3/36)、24.4％(11/45),x2=9.686,P＜0.01]발생솔현저승고,차이유통계학의의.원내[분별위0、5.6％(3/36)、15.6％ (7/45),x2=6.312,P＜0.05]、3개월후병사솔[분별위0、5.6％(3/36)、17.8％(8/45),x2=7.715,P＜0.05]현저승고,차이유통계학의의.결론 AMI조기지속혈당승고적환자원내병발증발생솔고,근기예후불가.
Objective To evaluate the disparities of in-hospital and short term prognosis of patients with different glycometabolic status in the early phase of acute myocardial infarction (AMI).Methods Glycometabolic status of consecutive 111 AMI patients without known diabetes mellitus was evaluated by means of continuous glucose monitoring,72 h blood glucose fluctuations were in continuous tracking from admitting to hospital,as the results assessed,all the patients were divided into AMI early blood sugar fluctuations:normal blood glucose group (NG group),had blood glucose elevated group (TH),and persistent hyperglycemia group (PH group).Patients with different glycometabolic status were compared between term of in-hospital and short term prognosis of AMI.Results There was no significant difference of infarction locations between AMI patients with varying glycometabolic status.Compared with patients of NG and TH,patients with PH presented higher prevalence of malicious arhythmia (10.0％ (3/30),11.1％ (4/36),31.1％ (14/45),x2 =7.347,P ＜ 0.05,cardiogenic shock (3.3％ (1/30),5.6％ (3/36),24.4％ (11/45),x2 =9.686,P ＜ 0.01).Mortality of inhospital(0,5.6％ (3/36),15.6％ (7/45),x2 =6.312,P ＜ 0.05)and after 3 month (0,5.6％ (3/36),17.8％(8/45),x2 =7.715,P ＜0.05)were higher in these patients.Conclusion Persistent hyperglycemia in early stage of AMI was associated with more complications and poor prognosis.
