论文部分内容阅读
目的探讨急性心肌梗死(简称心梗)患者血糖水平与院内发生恶性室性心律失常的关系。方法回顾分析急性心梗临床病例资料1 118例,根据入院后空腹血糖水平将心梗患者分为三组:血糖<6.99 mmol/L(A)组,7.00~11.09 mmol/L(B)组,≥11.10 mmol/L(C)组,按入院时有无糖尿病史分为非糖尿病组和糖尿病组,再将两组按血糖水平(标准相同)分为A1、B1、C1和A2、B2、C2亚组,分析不同组的心血管事件。结果 A、B与C组患者数量分别为808例(72.3%),239例,71例。A、B与C组恶性室性心律失常发生分别是50例(6.2%),19例(7.9%),14例(19.7%),三组之间有显著性差异(P<0.001)。恶性室性心律失常发生率在非糖尿病组(n=862)A1、B1、C1亚组中分别为5.9%(42例),10.2%(13例)与33.3%(8例),三组之间也有显著差异(P<0.001),而在糖尿病组中(n=256)恶性室性心律失常发生率分别为8.2%(8例),5.4%(6例)与12.8%(6例),三组之间无显著差异(P=0.277)。多因素logistic回归分析显示非糖尿病心梗患者入院空腹血糖≥11.10 mmol/L时院内恶性室性心律失常发生风险最高(OR=6.552,95%CI 2.551~16.828,P<0.001)。结论空腹血糖水平升高(≥11.10 mmol/L)增加急性心梗后院内发生恶性室性心律失常风险,尤其在非糖尿病患者中更为明显。
Objective To investigate the relationship between blood glucose level and malignant ventricular arrhythmia in patients with acute myocardial infarction (MI). Methods The data of 1 118 cases of acute myocardial infarction were retrospectively analyzed. According to the fasting blood glucose after admission, the patients with myocardial infarction were divided into three groups: blood glucose <6.99 mmol / L (A), 7.00-11.09 mmol / L (B) The patients were divided into non-diabetic group and diabetic group according to the presence or absence of diabetes mellitus on admission. The two groups were divided into A1, B1, C1 and A2, B2 and C2 according to the blood glucose level (same criteria) Subgroups, analyzing different groups of cardiovascular events. Results The number of patients in groups A, B and C were 808 (72.3%), 239 and 71, respectively. The incidence of malignant ventricular arrhythmias in group A, B and C were 50 cases (6.2%), 19 cases (7.9%) and 14 cases (19.7%), respectively. There were significant differences among the three groups (P <0.001). The incidence of malignant ventricular arrhythmia was 5.9% (42 cases), 10.2% (13 cases) and 33.3% (8 cases) in the non-diabetic group (n = 862) The incidence of malignant ventricular arrhythmias in diabetic group (n = 256) was 8.2% (8 cases), 5.4% (6 cases) and 12.8% (6 cases), respectively There was no significant difference between the three groups (P = 0.277). Multivariate logistic regression analysis showed that the highest risk of nocturnal ventricular arrhythmia was found in non-diabetic patients with fasting blood glucose≥11.10 mmol / L (OR = 6.552,95% CI 2.551-16.828, P <0.001). Conclusions Increased fasting plasma glucose (≥11.10 mmol / L) increases the risk of nociceptive ventricular arrhythmia in patients with acute myocardial infarction, especially in nondiabetic patients.