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目的探讨入院时血糖水平与接受直接冠状动脉介入术治疗的急性前壁心肌梗死(acute myocardial infarction,AMI)患者心功能的相关性。方法 362例发病时间<12h的前壁AMI患者行直接冠状动脉介入术,根据入院时血糖水平分为2组:血糖≥7.8mmol/L组(149例)与血糖<7.8mmol/L组(213例),分析2组患者临床特点及心功能。结果与血糖<7.8mmol/L组比较,血糖≥7.8mmol/L组患者高血压病史、糖尿病史、KillipⅢ及Ⅳ级、心力衰竭发生率明显升高,左室射血分数、KillipⅠ级、术后TIMI 3级血流及术后ST段回落率比率明显降低,差异有统计学意义(P<0.05);校正其他危险因素后,血糖≥7.8mmol/L是心力衰竭发生的独立影响因素(OR=1.314,95%CI:0.873～2.185,P=0.041)。结论入院时血糖水平高的前壁AMI患者心功能较差,心力衰竭发生率高。
Objective To investigate the correlation between the blood glucose level on admission and the cardiac function in patients with acute myocardial infarction (AMI) undergoing direct coronary intervention. Methods 362 AMI patients with anterior wall onset of less than 12 hours underwent direct coronary intervention and were divided into two groups according to their blood glucose levels at admission: blood glucose ≥ 7.8 mmol / L (149 cases) and blood glucose <7.8 mmol / L (213) Cases), analysis of two groups of patients with clinical features and cardiac function. Results Compared with blood glucose <7.8 mmol / L group, the history of hypertension, diabetes mellitus, Killip Ⅲ and Ⅳ, the incidence of heart failure in patients with blood glucose≥7.8mmol / L were significantly increased, the left ventricular ejection fraction, KillipⅠ, TIMI grade 3 blood flow and postoperative ST segment depression rate was significantly lower, the difference was statistically significant (P <0.05); correction of other risk factors, blood glucose ≥ 7.8mmol / L is an independent risk factor for heart failure (OR = 1.314, 95% CI: 0.873-2.185, P = 0.041). Conclusions AMI patients with high blood glucose levels on admission have poor cardiac function and high incidence of heart failure.