空腹血糖水平对老年急性冠脉综合征患者临床心血管事件及死亡率的影响

摘要

目的:探讨不同空腹血糖水平对老年急性冠脉综合征(ACS)患者近期和远期临床事件的影响.方法:将我院心脏中心2007年12月至2009年12月住院的老年ACS患者360例,根据入院首次空腹血糖水平分3组,A组(＜7.0mmol/L组),B组(7.0～11.0mmol/L组),和C组(＞11.1mmol/L组).对其住院期间临床心血管事件及出院6个月的总死亡率进行分析.结果:随着空腹血糖水平的增高,患者在住院期间急性心肌梗死、严重心律失常、心源性猝死、左室功能不全、心源性休克发生率与明显增高;与A组比较,随空腹血糖增高,患者出院6个月内的总死亡率逐渐增高,OR及95%可信期间分别为:B组2.25[1.74～2.710];C组6.06[4.78～9.8]; 经过Logistic多元逐步回归分析发现,住院首次空腹血糖与出院6个月的总死亡率显著相关.结论:随着空腹血糖水平的增高,老年ACS患者住院期间临床事件及出院6个月的总死亡率逐渐增加.%Objective:To investigate the short-term and long-term outcome of different fasting glucose in old acute coronary syndromespatients.Methods:360 patients who were diagnosed as having acute corconary syndromes in our Department of Cardiology from December 2007 to Decemeber 2009 were divided into three groups according to their first documented blood fasting glucose levels at first time during hospitalization,respectively;＜7.0mmol/L guoup(A guoup),7.0～11.1mmol/L guoup(B guoup)and ＞11.1 mmol/L guoup(C guoup).Analyze the clinical cardiovascular events during hospitalization and the 6-month postdischarge total mortality.Results:Higher fasting glucose levels were associated with an increase in the risk of in-hospital worse Prognosis,such as AMI,Severe arrhythmia,Cardiac sudden death,Heart failure of LV and cardiac shock.6-month postdischarge total mortality (odds ratios[95％ confidence intervarvals])vs A guoup,B guoup 2.25[1.74～2.710];C guoup 6.06[4.78～9.80];A multivariate logistic regression analysis indicates that fasting glucose levels and 6-month postdischarge total mortality have significant correlation.Conclusions:Short-term clinical cardiovascular events and 6-month postdischarge total mortality was increased significantly with higher fasting glucose levels in old patients of acute coronary syndromes.