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目的观察血糖对非ST段抬高心肌梗死经皮冠状动脉介入治疗(PCI)后心功能的影响。方法选取非ST段抬高心肌梗死PCI患者144例,根据血糖分为三组,A组<7.8mmol/L,68例,B组7.8～11.1mmol/L,43例,C组>11.1mmol/L,33例。术后1周内行超声心动测定左心室射血分数(LVEF)。结果B、C组患者年龄较大[(62.6±10.3)岁比(57.2±11.2)岁,P<0.05]。冠脉造影结果B、C组多支血管病变较多(67.4%、66.7%比50.0%,P<0.05)。PCI术后TIMI血流分级3级,三组差异无统计学意义(P>0.05)。左心室射血分数B、C组明显降低[(51.4±7.0)、(49.6±7.1)比(58.5±7.2),P<0.05]。30d内心脏不良事件发生率B、C组与A组比较差异虽无统计学意义,但有增加趋势。病死率C组明显多于A组(9.1%比1.5%,P<0.05)。结论血糖升高的急性非ST段抬高心肌梗死PCI患者较血糖正常者心功能差,心脏不良事件发生率高,病死率增加。
Objective To observe the effect of blood glucose on cardiac function after percutaneous coronary intervention (PCI) in patients with non-ST segment elevation myocardial infarction. Methods A total of 144 patients with non-ST-segment elevation myocardial infarction (PCI) were enrolled in this study. According to the blood glucose level, 68 patients were divided into three groups according to their blood glucose levels: 7.8-11.1 mmol / L in group A, 43.1 in group B and 11.1 mmol / L, 33 cases. One week after operation, left ventricular ejection fraction (LVEF) was measured by echocardiography. Results The patients in groups B and C were older (62.6 ± 10.3 years vs 57.2 ± 11.2 years, P <0.05). Results of coronary angiography showed that in group B and C, there were many multivessel lesions (67.4%, 66.7% vs 50.0%, P <0.05). TIMI flow grade 3 after PCI, there was no significant difference among the three groups (P> 0.05). Left ventricular ejection fraction B and C were significantly lower (51.4 ± 7.0, 49.6 ± 7.1, 58.5 ± 7.2, P <0.05). 30d, the incidence of adverse cardiac events B, C group and A group, although the difference was not statistically significant, but there is an increasing trend. The mortality was significantly higher in group C than in group A (9.1% vs 1.5%, P <0.05). Conclusions PCI patients with elevated blood glucose in patients with acute non-ST-elevation myocardial infarction have worse cardiac function, higher rates of cardiac adverse events, and increased mortality than those with normal glucose.