急性高血糖对老年急性心肌梗死患者预后的影响

目的探讨入院时高血糖对老年急性心肌梗死(AMI)患者住院期间预后的影响。方法不伴糖尿病的老年AMI患者490例,根据入院时血糖水平分为3组,正常组223例,血糖水平<6.1 mmol/L;轻度增高组150例,血糖水平6.1～7.8 mmol/L;高血糖组117例,血糖水平>7.8 mmol/L。对3组患者一般临床资料、主要并发症和病死率进行比较。结果高血糖组女性患者比例较多,与正常组和轻度增高组比较,差异有统计学意义(P<0.05);高血糖组患者肌酸激酶,肌酸激酶同工酶峰值高、血压低、心率快,与正常组和轻度增高组比较,差异有统计学意义(P<0.05);高血糖组患者住院期间病死率19.66%,与正常组和轻度增高组的8.07%、14.67%比较,差异有统计学意义(P<0.05);高血糖组住院期间并发症发生率较正常组和轻度增高组增高(P<0.05)。结论急性高血糖可能是不伴糖尿病的老年AMI患者预后不良的标志之一。

Influence of acute hyperglycemia on the prognosis of elderly patients with acute myocardial infarction

Objective To explore the influence of hyperglycemia on the prognosis of the elderly pa- tients with acute myocardial infarction (AMI) during hospital stay.Methods 490 aged AMI pa- tients without diabetes were divided into 3 groups according to the blood glucose level on admis- sion.Group Ⅰ included 223 cases with blood glucose<6.1 mmol/L,group Ⅱ included 150 cases with blood glucose between 6.1 and 7.8 mmol/L,and group Ⅲ included 117 cases with blood glu- cose>7.8 mmol/L.The basic clinical data,the main complication and the in-hospital mortality of the patients in the three groups were compared.Results Compared with the other two groups, the patients in the group Ⅲ had higher female number,higher concentrations of serum creatine phosphate kinase and serum creatine phosphate kinase isoenzymes and higher heart rates,but low er blood pressure,and the differences were significant.The in-hospital mortality in group Ⅲ was 19.66%,and in group Ⅱ and group Ⅰ was 14.67% and 8.07% respectively,the difference was significant.The difference of the incidence rates of cardiac shock and severe arrhythmia between group Ⅲ and group Ⅰ or group Ⅱ was significant.The incidence rates of heart failure showed significant difference between group Ⅲ and group Ⅰ.Conclusion Hyperglycemia may be one of the important markers of poor prognosis in the elderly non-diabetic patients with AMI.