糖尿病合并急性心肌梗死患者临床分析

摘要

Objective To evaluate the clinical characteristics and in - hospital mortality of acute myocardial infarction patients ( AMI) with diabetes mellitus( DM ) and to analyze the risk factors of in - hospital mortality of AMI. Methods A total of 126 patients with diagnosis of AMI complicated with or without DM admitted from 2007 to 2010 were analyzed to find out the clinical characteristics, in -hospital complications and mortality. Of them, 38 (30% ) were complicated with DM. Results In comparison with non - DM patients ( 14.7% ) , the females were predominant in number over males in the DM patient cohort(21.2% ) ( P < 0. 05). In DM group, incidence of multi -part infarction, analgesic AMI(36% ) ,the complication and death rate were all statiscally higher than non -DM group (P < 0. 05). Conclusion The patients combined with AMI normally have atypical signs,mostly analgesic AMI. They also have a preference to severe arrhythmia, heart failure and shock with higher death rate. The measures to alleviate complications such as timely treatment, controlling blood glucose are beneficial to reducing the death rate.%目的 研究急性心肌梗死(acute myocardial infarction,AMI)合并糖尿病(diabetes mellitus,DM)患者的临床特征及住院病死率,分析影响AMI预后的危险因素.方法 收集武汉大学人民医院2007 ～2010年126例AMI患者的临床资料、并发症及预后.按是否合并DM,分为DM组与非DM组,其中DM患者38例(30％),回顾性比较DM组与非DM组临床特征.结果 与非DM组(14.8％)相比,DM组女性较多(21％)(P＜0.01),DM发生无痛性急性心肌梗死的构成比(29.5％)较非糖尿病者发生的构成比(19％)高(P＜0.01)；发生大面积梗死的构成比(36％)比对照组的发生构成比(16.9％)明显升高(P＜0.05)；严重心律失常的发生构成比(36％)及死亡构成比(21％)均明显高于非糖尿病者严重心律失常的发生构成比(16％)及死亡构成比(13％).结论 DM合并AMI患者临床症状不典型,以无痛性AMI多见,易发生严重心律失常、心力衰竭、休克等并发症,病死率高,及时治疗、积极控制血糖等以减少并发症,降低病死率.