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目的探讨老年2型糖尿病(T2DM)并发急性心肌梗死(AMI)的临床特点及预后的影响因素。方法对60岁以上58例老年2型糖尿病患者并发急性心肌梗死(DM-AMI)与40例非糖尿病急性心肌梗死(NDM-AMI)患者进行临床分析,比较两组临床特点,探讨其对预后的影响因素。结果 T2DM并发急性心肌梗死的主要临床特点为胸闷、心悸、倦怠乏力、呼吸困难、心律失常、心力衰竭、心源性休克及恶心、呕吐、出汗,12例患者低血糖后并发急性心肌梗死。糖尿病组急性心肌梗死静息状态发病率高,无痛性居多,血脂紊乱多为混合型,多支病变发生率高,且严重心脏事件的总发生率均显著高于对照组。结论积极控制血糖,预防低血糖,老年2型DM患者合并AMI预后差,病死率高。糖尿病是心肌梗死的主要危险因素,心肌梗死是糖尿病的重要死亡原因。应高度重视并积极的处理。
Objective To investigate the clinical characteristics and prognostic factors of senile type 2 diabetes mellitus (T2DM) complicated with acute myocardial infarction (AMI). Methods The clinical data of 58 elderly patients with type 2 diabetes over 60 years old with acute myocardial infarction (DM-AMI) and 40 patients with non-diabetic acute myocardial infarction (NDM-AMI) were analyzed. The clinical features of the two groups were compared and their prognosis Influencing factors. Results The main clinical features of T2DM complicated with acute myocardial infarction were chest tightness, palpitations, fatigue, dyspnea, arrhythmia, heart failure, cardiogenic shock and nausea, vomiting and sweating. 12 cases had acute myocardial infarction after hypoglycemia. Acute myocardial infarction in diabetic patients with high incidence of morbidity, painless, mostly dyslipidemic mixed type, high incidence of multiple lesions, and the overall incidence of serious cardiac events were significantly higher than the control group. Conclusion Positive control of blood glucose, prevention of hypoglycemia, elderly patients with type 2 diabetes mellitus with poor prognosis and high mortality. Diabetes mellitus is a major risk factor for myocardial infarction. Myocardial infarction is an important cause of death from diabetes mellitus. Should attach great importance and actively deal with.