糖尿病对老年急性心肌梗死患者近期预后的影响.docVIP

糖尿病对老年急性心肌梗死患者近期预后的影响 　　[摘要]目的 评价糖尿病合并老年急性心肌梗死（AMI）患者的临床特点及对近期预后的影响。方法 连续入选老年AMI患者235例，其中糖尿病组62例（26.4%），非糖尿病组173例（73.6%），比较两组患者临床特点、介入治疗及院内预后的差异，随访1年MACE，评价影响患者死亡及MACE的危险因素。结果 与非糖尿病组比较，糖尿病组患者发病年龄偏小、合并高血压、高脂血症等多重危险因素，脑卒中比例较高。两组接受PCI治疗比例相近，其冠脉病变部位、程度方面无显著差异。院内死亡（9.7%vs.15.0%，P=0.389）、随访1年主要不良心血管事件发生率[19.4%vs.22.5%，P=0.720]两组无显著差异。多因素logistic回归分析显示，killip分级（OR=1.805，95%CI：1.293～2.521，P=0.001）是院内死亡的独立危险因素； killip分级（OR=1.543，95%CI：1.171～2.033，P=0.002） 是1年MACE的独立危险因素，PCI （OR=0.053，95%CI：0.012～0.227，P=0.000） 是1年MACE的保护因素。结论 糖尿病患者常合并多重危险因素，但不是老年急性心肌跟死患者的近期预后的独立危险因素。 　　[关键词]糖尿病；老年；急性心肌梗死；预后 　　[中图分类号]R4 [文献标识码]A [文章编号]1674-0742（2015）04（b）-0025-04 　　The Effect of Diabetes on Short-term Prognosis in Elderly Patients with Acute Myocardial Infarction 　　LIU Guangbin 　　Department of Cardiovascular， The First Hospital of Yangzhou City， Yangzhou， Jiangsu Province， 225001 China 　　[Abstract]Objective To evaluate the effects of Clinical characteristics and short-term clinical outcomes in elderly patients with diabetes combined with acute myocardial infarction （AMI）.Methods A total of 235 consecutive elderly patients [diabetes 62（26.4%） and non diabetes 173（73.6%）] with acute myocardial infarction were included. Compared the difference of clinical characteristics， Interventional therapy and in-hospital prognosis of the two groups， 1 year flow-up， evaluated risk factor for influencing the mortality and MACE in patients. Results Diabetes group were younger， combined with hypertension， hyperlipidemia and other multiple risk factors， have a higher proportion of stroke compared with non diabetes group. The two group patients have similar proportion to receive PCI treatment， and no significant difference in severity and location of the lesion were found. There were no significant difference of In-hospital mortality [9.7%vs.15%， P=0.389] and 1 year MACE [19.4%vs.22.5%， P=0.720] between two groups. Multi-logistic regression analysis showed that killip Classification （OR=1.805， 95%CI：1