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目的探讨急性心肌梗死患者早期高血糖状态对病情的影响,为临床干预提供依据。方法根据患者入院3d内血糖检测情况,将126例无糖尿病史的急性心肌梗死患者分为正常血糖组及高血糖组。比较2组住院期间心血管事件发生率及治疗后3个月心功能指标的差别。结果 126例患者中早期高血糖者80例(63.49%),血糖正常者46例(36.51%)。高血糖组患者住院期间心力衰竭(22.50%vs4.35%,P<0.05)及严重心律失常发生率明显高于正常血糖组(26.25%vs4.35%,P<0.05);左室射血分数(LVEF)及二尖瓣舒张早期血流峰速度(E)明显低于正常血糖组(P均<0.05),而左心室收缩末期容积(LVESV)较正常血糖组明显增加(P<0.05)。结论急性心肌梗死早期血糖升高显著增加患者心血管事件发生率,心功能损害明显,提示患者预后不良。
Objective To investigate the effect of early hyperglycemia in patients with acute myocardial infarction on the condition and provide the basis for clinical intervention. Methods According to the blood sugar level in patients admitted to hospital for three days, 126 patients with acute myocardial infarction without diabetes mellitus were divided into normal glucose group and hyperglycemia group. The incidence of cardiovascular events during hospitalization and the difference of cardiac function between the two groups after 3 months of treatment were compared. Results Among the 126 patients, 80 (63.49%) had early hyperglycemia and 46 (36.51%) had normal glucose. The incidence of heart failure (22.50% vs 4.35%, P <0.05) and severe arrhythmia in patients with hyperglycemia during hospitalization were significantly higher than those in patients with normal glucose (26.25% vs 4.35%, P <0.05) (LVEF) and mitral early diastolic velocity (E) were significantly lower than those in normal blood glucose group (all P <0.05), while left ventricular end systolic volume (LVESV) was significantly higher than that in normal blood glucose group (P <0.05). Conclusions The elevated blood glucose in the early stage of acute myocardial infarction significantly increases the incidence of cardiovascular events and the impairment of cardiac function, suggesting that the prognosis is poor.