山东医药2017，Vol.57Issue(1)：19-21,3.DOI:10.3969/j.issn.1002-266X.2017.01.006
急性心肌梗死合并糖尿病患者冠脉介入治疗后心室重构的变化
Changes of ventricular remodeling in patients with acute myocardial infarction combined with diabetes mellitus after PCI
摘要
Abstract
Objective To investigate the influence of diabetes mellitus (DM)on ventricular remodeling in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention (PCI).Methods Totally 115 pa-tients with acute ST-segment elevation cardial infarction (STEMI)underwent PCI,including 37 cases of patients with DM (AMI with DM,DMgroup)and 78 cases without DM(AMI without DM,non-DMgroup).The levels of CPK,CK-MB, TC,HDL-C,LDL-C,TG,FPG,and HbAc1 were detected by ELASA.The left ventricular end-diastolic volume (LV-EDV),left ventricular end-systolic volume (LVESV),left ventricular ejection fraction (LVEF),E /A,heart isovolumic relaxation time (IVRT),and wall motion score index (WMSI)was determined by echocardiography in the two groups.The left ventricular remodeling and heart failure,and the incidence rate of ST-segment fall >70% was observed in the two groups.Results All patients were followed up for 6 months.In the DMgroup,1 lost to follow-up,1 died,while in the non-DMgroup,4 lost to follow-up,and 1 died.The rest of 108 patients completed follow-up process.After 6-month PCI, no statistical difference was found in CK,CK-MB,TC,HDL-C,LDL-C,and TG between these two groups (all P >0.05),while significant difference was found in FPG and HbA1c between these two groups (all P <0.05).No statistical difference was found in LVEDV,LVEF,E /A and IVRT between these two groups (all P >0.05).LVESV,WMSI had statitical difference (all P <0.05).Patients with DMshowed a significantly higher rate of ST-segment fall >70% as com-pared with that of patients without DM(17.14% vs 47.94%,P =0.003).Despite a similar incidence of LV remodeling between DMand non-DMgroups (37.14% vs 28.76%,P =0.082),symptoms of heart failure were significantly more in diabetic patients (37.14% vs 19.17%,P =0.008)at 6-month follow-up.Conclusion The risk of heart failure after PCI in patients with acute myocardial infarction and diabetes mellitus is higher than that in non-diabetic patients,but there is no direct relationship with ventricular remodeling.关键词
急性心肌梗死/冠脉介入治疗/心室重构/糖尿病Key words
acute myocardial infarction/percutaneous coronary intervention/ventricular remodeling/diabetes mellitus分类
医药卫生引用本文复制引用
李亚芹,王乾一,徐占稳,康世鑫,魏媛,李靖..急性心肌梗死合并糖尿病患者冠脉介入治疗后心室重构的变化[J].山东医药,2017,57(1):19-21,3.基金项目
河北省科技厅科技支撑计划资助项目（14277786D）。 （）
