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目的探讨2型糖尿病并发急性心肌梗死(AMI)的临床特点。方法对288例 AMI 患者进行回顾分析,将其分成两组,其中急性心肌梗死合并糖尿病组69例(24.0%),急性心肌梗死不合并糖尿病组219例,比较两组患者的病史、临床表现、化验室检查以及死亡情况。结果两组病人的年龄、性别、心绞痛史、陈旧性心肌梗死差异无显著性(P>0.05),而脑血管病史高血压病史两组差异有显著性(分别 P<0.05和 P<0.01);临床表现方面无痛性心肌梗死,急性心功能不全两组差异有显著性(P<0.01),心源性休克、高脂血症两组间亦差异有显著性(P<0.05),而梗死分布差异无显著性(P>0.05);化验室检查中空腹血糖两组差异有显著性(P<0.01),CK、CK-Mb 两组差异无显著性;死亡情况:急性心肌梗死合并糖尿病组死亡19例(27.5%),急性心肌梗死不合并糖尿病组死亡27例(12.3%)。两组比较差异有显著性(P<0.005),两组死因分析无明显差异,但泵衰竭均为两组的主要死因。结论糖尿病合并心肌梗死时病情重,病死率高。
Objective To investigate the clinical features of type 2 diabetes mellitus complicated with acute myocardial infarction (AMI). Methods A total of 288 patients with AMI were retrospectively analyzed and divided into two groups: 69 cases (24.0%) with acute myocardial infarction complicated by diabetes mellitus and 219 cases without acute myocardial infarction with diabetes mellitus. The medical history, clinical manifestations, Laboratory tests and deaths. Results There were no significant differences in age, sex, angina pectoris history and old myocardial infarction between the two groups (P> 0.05), but there was a significant difference between the two groups in history of cerebrovascular disease (P <0.05 and P <0.01, respectively). Clinical manifestations of painless myocardial infarction, acute heart failure were significantly different between the two groups (P <0.01), cardiogenic shock, hyperlipidemia also showed significant difference between the two groups (P <0.05), and infarction There was no significant difference between the two groups (P> 0.05). There was a significant difference between the two groups in fasting blood glucose test (P <0.01) 19 cases died (27.5%), 27 cases (12.3%) died of acute myocardial infarction without diabetes mellitus. There was significant difference between the two groups (P <0.005). There was no significant difference between the two groups in the analysis of cause of death, but pump failure was the main cause of death in both groups. Conclusion Diabetes combined with myocardial infarction severe illness, high mortality.