【摘要】 目的探讨应激性血糖增高对急诊冠脉介入治疗(PCI)的ST段抬高型急性心肌梗死(AMI)近期预后的影响。方法将急诊行PCI治疗的ST段抬高型AMI患者410例依据糖尿病病史及入院随机血糖水平随机分为四组:组1(n=288):随机血糖正常的非糖尿病患者;组2(n=30):随机血糖正常的糖尿病患者;组3(n=54):随机血糖增高的非糖尿病患者;组4(n=38):随机血糖增高的糖尿病患者。比较各组患者的年龄、性别、入院24h内随机血糖、糖化血红蛋白(HbA1c)、心肌酶峰值、TIMI血流恢复情况及30d病死率。结果四组住院病死率分别为4.2%、3.4%、7.5%、5.9%(P<0.01)。入院随机血糖增高的糖尿病组及非糖尿病组急诊PCI术后30d病死率高于随机血糖正常组,其中随机血糖增高的非糖尿病组30d病死率高于糖尿病组。结论应激性血糖增高是影响ST段抬高型AMI急诊PCI疗效的重要指标之一,与近期预后密切相关。更多还原

【Abstract】 Objective To investigate the recent prognosis of stress hyperglycemia for the emergency percuta- neous coronary intervention(PCI)with ST-segment elevation acute myocardial infarction(AMI).Methods 410 pa- tients treated by emergency PCI were chosen.According to a history of diabetes and blood glucose levels,they were randomly divided into four groups:group 1(n = 288):random blood glucose normal and non-diabetic patients;group 2(n = 30):random normal blood glucose in diabetic patients;group 3(n = 54):random plasma glucose level and non- diabetic patients;group 4(n = 38):high random plasma glucose level in diabetic patients.Age,gender,hospital within 24 hours with random glucose,glycated hemoglobin(HbA1c),peak creatine kinase,TIMI flow recovery and 30-day mortality of the patients were compared.Results Mortality of four groups were 4.2%,3.4%,7.5% and 5.9% re- spectively(P<0.01).Plasma glucose level in diabetic and non-diabetic group after PCI and 30-day mortality were higher than those of normal blood sugar team.30-day mortality rate of non-diabetic group in which blood glucose randomly increased was higher than that of the diabetic group.Conclusions Stressed hyperglycemia would influence the ST-segment elevation AMI PCI efficacy and was one of the important indicators,which was closely related with the short-term prognosis.更多还原