论文部分内容阅读
目的:观察入院时血糖浓度对急性ST段抬高型心肌梗死(STEMI)患者急诊溶栓治疗的影响。方法:入选STEMI患者132例,分为血糖≤7.1mmol/L组(血糖正常组),7.1～11.1mmol/L组(血糖偏高组),血糖≥11.1mmol/L组(高血糖组)。所有患者于心肌梗死发作3h内采用rt-PA进行静脉溶栓。观察各组血管再通指标﹑溶栓后出血并发症及终点事件发生率。结果:血糖正常组﹑血糖偏高组﹑高血糖组在溶栓后90min时的再通率分别为78.8%、66.0%、52.2%,差异有统计学意义(P<0.05)。溶栓治疗后30d内,3组出血并发症差异无统计学意义(P>0.05),而高血糖组再梗死、心力衰竭及死亡的发生率明显增加(P<0.05)。结论:高血糖水平可降低STEMI患者早期溶栓的再通率,增加终点事件发生率。
Objective: To observe the effect of blood glucose concentration on emergency thrombolytic therapy in patients with acute ST-segment elevation myocardial infarction (STEMI) on admission. Methods: A total of 132 patients with STEMI were enrolled in this study. They were divided into seven groups: blood glucose ≤7.1mmol / L (normal blood glucose group), 7.1 ~ 11.1mmol / L group (hyperglycemia group) and blood glucose≥11.1mmol / L group (hyperglycemia group). All patients underwent intravenous thrombolysis with rt-PA within 3 h of onset of myocardial infarction. The indexes of recanalization, bleeding complication after thrombolysis and the incidence of end point were observed. Results: The recanalization rates of normal blood glucose group, high blood glucose group and high blood glucose group at 90 minutes after thrombolysis were 78.8%, 66.0% and 52.2%, respectively. The difference was statistically significant (P <0.05). Within 30 days after thrombolytic therapy, there was no significant difference in the complication of hemorrhage between the three groups (P> 0.05), while the incidence of re-infarction, heart failure and death in hyperglycemia group was significantly increased (P <0.05). Conclusion: Hyperglycemia can reduce the rate of early thrombolysis in STEMI patients and increase the incidence of end-point events.