论文部分内容阅读
目的:研究入院空腹血糖与非糖尿病患者急性心肌梗死远期预后的相关性。方法:收集2005-2010年在广东省人民医院确诊的急性心肌梗死患者564例,入院后监测空腹血糖并予分组:A组,<6.1mmol/L(152例);B组,6.1~7.0 mmol/L(124例);C组,7.0~11.1 mmol/L(240例);D组,>11.1 mmol/L(48例)。分析各组36个月后的心源性死亡率及不良事件。结果:D组心源性休克史较其他组明显偏高(P=0.004);左室收缩功能(LVEF)较其他组偏低(P=0.018);而肌酐、尿素氮均较其他组明显升高(P值分别为:0.018、0.038)。多变量Logistic回归分析提示,D组较正常血糖组死亡率明显增多,且OR为4.476(P<0.001)。次要研究终点结果提示非糖尿病患者急性心肌梗死时,空腹血糖水平与反复心衰发作明显相关(P<0.001)。Kaplan-Meier法分析发现:D组平均生存时间明显低于其他3组(P<0.001)。结论:非糖尿病患者发生急性心肌梗死时,空腹血糖水平越高,提示远期预后越差,且与反复发作心衰明显相关。
Objective: To study the relationship between fasting blood glucose on admission and long-term prognosis of acute myocardial infarction in non-diabetic patients. Methods: A total of 564 acute myocardial infarction patients diagnosed in Guangdong Provincial People ’s Hospital from 2005 to 2010 were collected. After fasting, fasting blood glucose (FBG) was monitored and divided into group A (<6.1 mmol / L), group B (6.1-7.0 mmol / L (124 cases); Group C, 7.0-11.1 mmol / L (240 cases); Group D,> 11.1 mmol / L (48 cases). Cardiac mortality and adverse events were analyzed after 36 months in each group. Results: The history of cardiogenic shock in group D was significantly higher than that in other groups (P = 0.004); the left ventricular systolic function (LVEF) was lower than other groups (P = 0.018); creatinine and urea nitrogen High (P = 0.018, 0.038, respectively). Multivariate logistic regression analysis showed that the mortality of group D was significantly higher than that of normal group (OR = 4.476, P <0.001). Secondary end-point results suggest that fasting plasma glucose levels are significantly associated with recurrent heart failure in non-diabetic patients with acute myocardial infarction (P <0.001). Kaplan-Meier analysis showed that the average survival time in group D was significantly lower than the other three groups (P <0.001). Conclusions: The fasting blood glucose level in non-diabetic patients with acute myocardial infarction suggests that the long-term prognosis is worse, and is significantly associated with recurrent heart failure.