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目的探讨急性心肌梗死患者入院时空腹血糖水平与急性期临床心血管事件发生率之间的关系,为临床实践提供理论依据。方法选取2005年1月至2007年12月急性心肌梗死发病24h之内入本院的138例患者为研究对象,根据入院后第2天空腹血糖水平和既往有无糖尿病史分为2组:糖代谢正常组:血糖≤6.0mmol/L;糖代谢异常组:血糖>6.0mmol/L或既往确诊糖尿病者,比较2组患者一般临床资料和住院期间心血管事件(充血性心力衰竭、严重心律失常、心源性休克、心源性死亡)的发生情况。结果糖代谢异常组严重心律失常、充血性心衰、心源性休克的发生率显著高于糖代谢正常组(P<0.05),心源性死亡两组之间没有统计学意义。结论糖代谢异常的急性心肌梗死患者急性期心血管事件的发生率显著增高;空腹血糖水平是急性心肌梗死患者近期充血性心衰、心源性死亡的主要影响因素;心功能(Killip分级)是急性心肌梗死患者近期心源性休克、严重心律失常。心源性死亡的主要影响因素。
Objective To investigate the relationship between fasting blood glucose (FBG) level and the incidence of acute cardiovascular events in patients with acute myocardial infarction (AMI) and provide a theoretical basis for clinical practice. Methods A total of 138 patients admitted to our hospital from January 2005 to December 2007 were enrolled in this study. According to the fasting blood glucose level on the second day after admission and the past history of no history of diabetes mellitus, the patients were divided into two groups: Metabolic normal group: blood glucose ≤ 6.0mmol / L; abnormal glucose metabolism group: blood glucose> 6.0mmol / L or previously diagnosed with diabetes mellitus, the general clinical data and hospitalized two groups of cardiovascular events (congestive heart failure, severe arrhythmia , Cardiogenic shock, cardiac death) of the occurrence. Results The incidence of severe arrhythmia, congestive heart failure and cardiogenic shock in the group with abnormal glucose metabolism was significantly higher than that in the normal glucose metabolism group (P <0.05). There was no significant difference between the two groups in cardiac death. Conclusions The incidence of acute cardiovascular events in patients with acute myocardial infarction with abnormal glucose metabolism is significantly higher. Fasting plasma glucose level is the major influencing factor of recent congestive heart failure and cardiac death in patients with acute myocardial infarction. Killip grade Cardiac shock in patients with acute myocardial infarction, severe arrhythmia. Cardiovascular deaths of the main factors.