【摘要】 目的探究ST段抬高指数(∑STI)回落对合并2型糖尿病的急性ST段抬高型心肌梗死(STEMI)患者近期预后的影响。方法回顾性分析2016年1月至2020年8月在盐城市第三人民医院心内科住院治疗的102例发病12h内且合并有2型糖尿病的STEMI患者的临床资料,所有患者均行急诊冠状动脉介入治疗(PCI);根据术后∑STI回落情况分为ST段回落组72例和非ST段回落组30例。比较两组患者的临床特征和首次医疗接触至球囊扩张时间(FMC-to-B)、肌酸激酶同工酶(CK-MB)和肌钙蛋白I (CTnI)峰值、前壁心肌梗死比例、入院时心功能Killip分级、术中心肌梗死溶栓(TIMI)血流、住院期间的恶性心律失常发生率、主要出血发生率、血栓形成发生率、左室射血分数(LVEF)和主要心脏不良事件(MACE)发生率等指标。结果两组患者的临床特征和FMC-to-B、前壁心肌梗死比例、入院时心功能Killip分级、术中TIMI3级血流发生率、住院期间的主要出血发生率比较差异均无统计学意义(P>0.05);ST段回落组和非ST段回落组患者的CK-MB峰值[(544.99±140.04) U/L vs (700.40±215.90) U/L]、CTn I峰值[(39.76±16.58) ng/mL vs (49.75±19.11) ng/mL]、住院期间MACE发生率(2.8%vs 26.7%)、恶性心律失常发生率(4.2%vs 23.3%)和血栓形成发生率(2.8%vs 20.0%)比较,ST段回落组明显低于非ST段回落组,差异均有统计学意义(P<0.05);ST段回落组患者的住院期间LVEF为(53.54±6.88)%,明显高于非ST段回落组的(42.43±7.59)%,差异有统计学意义(P<0.05)。结论 ST段抬高指数回落对合并2型糖尿病的急性ST段抬高型心肌梗死患者行急诊PCI术后的近期预后有良好的预测作用。更多还原

【Abstract】 Objective To investigate the effect of ST-segment elevation index( ∑ STI) resolution on short-term prognosis in patients with type 2 diabetes mellitus and ST-segment elevation acute myocardial infarction(STEMI). Methods From January 2016 to August 2020, 102 STEMI patients with type 2 diabetes mellitus were hospitalized in the Department of Cardiology, the Third People’s Hospital of Yancheng City. All patients underwent emergency percutaneous coronary intervention(PCI). According to the circumstance of ∑STI resolution after PCI, they were divided into ST resolution group(n=72, ∑ STI resolution≥50%) and non-ST-resolution group(n=30, ∑ STI resolution<50%).The clinical features, first medical contact to balloon dilation time(FMC-to-B), the peak value of CK-MB and CTn I, the rate of anterior myocardial infarction, Killip classification of cardiac function on admission, intraoperative thrombolysis in myocardial infarction(TIMI) blood flow, the rate of malignant arrhythmia, the rate of major hemorrhage, the rate of formation thrombosis, the left ventricular ejection fraction(LVEF) and the rate of major adverse cardiac events(MACE) in hospital were compared between two groups. Results There were no statistical differences in the clinical features,FMC-to-B, ratio of anterior myocardial infarction, Killip classification of cardiac function on admission, intraoperative TIMI blood flow and the rate of major hemorrhage in hospital between two groups(P>0.05); the peak value of CK-MB, the peak value of CTn I, the rate of MACE, the rate of malignant arrhythmia, and the rate of formation thrombosis during hospitalization in ST resolution group were(544.99 ± 140.04) U/L,(39.76 ± 16.58) ng/m L, 2.8%, 4.2%, 2.8%, respectively,which were significantly lower than corresponding(700.40±215.90) U/L,(49.75±19.11) ng/m L, 26.7%, 23.3%, 20.0% in non-ST resolution group(all P<0.05). The LVEF in hospital in ST resolution group were(53.54±6.88)%, which were significantly higher than(42.43±7.59)% in non-ST resolution group(P<0.05). Conclusion The resolution of ∑STI can predict the short-term prognosis of patients with type 2 diabetes mellitus and STEMI underwent emergency PCI.更多还原