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目的探讨因急性心肌梗死住院的老年2型糖尿病患者入院早期血糖波动程度和心功能受损及恢复的关系。方法采用动态血糖监测系统测定88例老年2型糖尿病并急性心肌梗死患者早期血糖水平,根据平均血糖波动幅度分为血糖波动正常组(NGF组)18例、轻微血糖波动组(MGF组)30例和严重血糖波动组(SGF组)40例,评估3组入院时与3个月后心功能状态和超声心动图指标。结果入院时MGF组左室射血分数明显低于NGF组(P<0.01),左心室收缩末期容积明显高于NGF组(P<0.01);入院时及3个月后,SGF组KillipⅡ级及以上比例、左心室收缩末期容积和室壁运动积分指数均明显高于NGF组和MGF组,左室射血分数均明显低于NGF组和MGF组(P<0.05);3个月后NGF组和MGF组左室射血分数明显高于入院时(P<0.01),2组比较差异无统计学意义(P>0.05);SGF组超声心动图指标与治疗前比较差异无统计学意义(P>0.05)。结论老年2型糖尿病患者心肌梗死早期易出现血糖异常波动,其中严重血糖波动的患者心功能受损更严重,且不易恢复。
Objective To investigate the relationship between the degree of blood glucose fluctuation and the impaired cardiac function and recovery of elderly patients with type 2 diabetes who are hospitalized with acute myocardial infarction in the early admission. Methods The blood glucose level of 88 elderly patients with type 2 diabetes mellitus and acute myocardial infarction was measured by dynamic blood glucose monitoring system. According to the average blood glucose level, 18 patients were divided into normal glucose tolerance group (NGF group), 30 mild glucose tolerance group (MGF group) And severe blood glucose fluctuation group (SGF group) 40 cases, 3 groups were assessed at admission and 3 months after cardiac function and echocardiographic parameters. Results The left ventricular ejection fraction of MGF group was significantly lower than that of NGF group (P <0.01), and the volume of left ventricular end-systolic phase was significantly higher than that of NGF group (P <0.01). On admission and 3 months later, Compared with NGF group and MGF group, left ventricular ejection fraction and left ventricular ejection fraction were significantly lower than those in NGF group and MGF group (P <0.05). After 3 months, NGF group and NGF group The left ventricular ejection fraction in MGF group was significantly higher than that in admission (P <0.01), but there was no significant difference between the two groups (P> 0.05). There was no significant difference in echocardiographic parameters between SGF group and before treatment (P> 0.05). Conclusion The elderly patients with type 2 diabetes mellitus tend to have abnormal blood glucose fluctuations in the early stage of myocardial infarction. Patients with severe blood glucose fluctuation suffer more severe cardiac dysfunction and are not easy to recover.