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目的:探讨入院血糖水平对无糖尿病病史的急性心肌梗死(AM I)患者预后的影响。方法:选择737例无糖尿病病史的急性心肌梗死患者,根据其入院后血糖水平分为3组,第1组为357例血糖水平<6.1 mmol/L者;第2组为228例血糖水平在6.1~7.8mmol/L者;第3组为152例血糖水平>7.8mmol/L者。对3组患者的一般临床情况、梗死部位、主要并发症发生率和病死率进行比较。结果:第2、3组女性患者所占比例较高,平均年龄相对较高、梗死前心绞痛症状较少、心率较快、血压较低。组间梗死部位比较的差异无统计学意义(P>0.05)。第2组患者住院期间在心力衰竭、严重心律失常、心源性休克的发生率和病死率方面显著高于第1组患者(P<0.05);第3组主要并发症的发生率和病死率较第1、2组均显著增高,差异有统计学意义(P<0.05)。结论:无糖尿病病史AM I患者中,血糖水平较高者的住院期间主要并发症发生率和病死率显著增加,预后较差。
Objective: To investigate the effect of admission blood glucose on the prognosis of patients with acute myocardial infarction (AMI) without a history of diabetes mellitus. Methods: A total of 737 patients with acute myocardial infarction without diabetes mellitus were enrolled and divided into 3 groups according to their post-admission blood glucose levels: 357 patients with blood glucose level <6.1 mmol / L in group 1; 228 patients with blood glucose level of 6.1 ~ 7.8mmol / L; the third group of 152 patients with blood glucose levels> 7.8mmol / L were. The general clinical conditions, infarct size, incidence of major complications and mortality in the three groups were compared. Results: The proportion of female patients in groups 2 and 3 was higher, the average age was relatively higher, the symptoms of pre-infarction angina were less, the heart rate was faster and the blood pressure was lower. There was no significant difference in infarct size between groups (P> 0.05). The incidence of heart failure, severe arrhythmia, cardiogenic shock and mortality in patients in group 2 were significantly higher than those in patients in group 1 during hospitalization (P <0.05). The incidence of major complications and mortality in group 3 Compared with the first and the second group were significantly increased, the difference was statistically significant (P <0.05). CONCLUSION: Among the AMI patients without a history of diabetes mellitus, the incidence of major complications and mortality during hospitalization with higher blood glucose levels are significantly increased, with a poorer prognosis.