高龄男性急性冠脉综合征合并2型糖尿病患者的临床分析

目的：探讨高龄男性急性冠脉综合征（ACS）合并2型糖尿病患者的临床特征。方法：将70例研究对象分为合并2型糖尿病组及不合并2型糖尿病组（对照组），回顾性分析两组心血管危险因素等的差异，观察两组患者发病情况及住院期间心力衰竭、恶性心律失常、肺部感染、心源性休克、死亡等不良事件的发生率。结果：与对照组比较，糖尿病组高甘油三酯血症的比例更高（P〈0．05）、肾功能损伤更为严重（P〈0．01）、既往发生急性心肌梗塞（AMI）和脑卒中的比例更高（P均〈0．05）；糖尿病组心力衰竭（P〈0．01）、肺部感染（P〈0．05）、心源性休克（P〈0．05）发生率明显高于对照组。两组在恶性心律失常的发生率方面无明显差别。结论：高龄男性急性冠脉综合征合并糖尿病的患者肾功能损伤加重，心力衰竭、血脂异常发生率更高，预后更差，更需加强综合治疗。

Clinical study of acute coronary syndromes complicated with type 2 diabetes in aged male patients

Objective： To study clinical features of acute coronary syndromes （ACS） patients associated with type 2 diabetes mellitus （DM） in aged male patients. Methods： The 70 ACS cases were divided into two groups based on concurrence with DM （DM group） or not （control group）, to analyze their distinction in cardiovascular risk factors and past medical history, and to observe the difference of morbidity, incidence of heart failure, malignance arrhythmia, pulmonary infection, cardiogenic shock and death between two groups while hospitalization. Results： Compared with control group the DM group showed more proportion of hypertriglyceridemia （P〈0. 05） and kidney dysfunction （P〈0.01）, higher rate of myocardial infarction and cerebral apoplexy in the past （P〈0. 05 all） ; furthermore, the incidence of heart failure was more, up to 43.8% （P〈0. 01）, they also had higher rate of pulmonary infection, cardiogenic shock （P〈 0. 05 all）, but the two groups displayed no marked difference in the rate of malignance arrhythmia, Conclusion： The aged male patients with ACS accompanied by type 2 diabetes present more complication and poorer prognosis. They need more control of cardiovascular risk factors and combined modality therapy.