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目的探讨糖尿病(DM)患者发生急性心肌梗死(AMI)的临床特点、促发因素、疗效和转归。方法回顾性对比分析我院住院的2005年1月到2008年12月186例急性心肌梗死病人溶栓治疗资料分析,对糖尿病发生急性心肌梗死组(A组,89例)与非糖尿病发生急性心肌梗死组(B组,97例)的发病时状态,临床特点及相关检查资料进行对照研究,比较两组急性心肌梗死有无不同。结果与B组比较,A组发病年龄早,安静状态下起病多,无痛性急性心肌梗死多,病变部位较弥散,血甘油三酯高,严重并发症及心力衰竭发生率高,溶栓治疗再灌注率低,死亡率高,P<0.01及0.05;其促发因素集中在过度饮食、失眠、情绪激动、过度劳累及停用药物。结论糖尿病患者发生急性心肌梗死发病年龄早,起病不典型,病变部位多,常呈无痛型,严重心脏并发症多,溶栓疗法再灌注率低,住院病死率高,预后差。
Objective To investigate the clinical features, the causes, the curative effects and the prognosis of acute myocardial infarction (AMI) in patients with diabetes mellitus (DM). Methods A retrospective analysis of hospitalized in our hospital from January 2005 to December 2008 186 cases of acute myocardial infarction in patients with thrombolytic therapy data analysis of acute myocardial infarction in diabetic group (A group, 89 cases) and non-diabetic patients with acute myocardial infarction Infarction group (group B, 97 cases) at the onset of the state, clinical features and related examination data were compared to compare the two groups with or without different acute myocardial infarction. Results Compared with group B, group A had earlier onset, more onset in silent state, more painless acute myocardial infarction, more diffuse lesion, high triglycerides, severe complications and higher incidence of heart failure. Thrombolysis The reperfusion rate was low and the mortality rate was high (P <0.01 and 0.05). The main triggers were over-eating, insomnia, agitation, over-exertion and drug discontinuation. Conclusion The incidence of acute myocardial infarction in diabetic patients is very early, with atypical onset, multiple lesions, often painless type, severe cardiac complications, low thrombolysis reperfusion rate, high in-hospital mortality and poor prognosis.