目的 观察糖尿病(DM)对接受直接经皮冠状动脉介入治疗(PCI)的急性心肌梗死(AMI)患者预后的影响.方法 回顾性分析因AMI于2010-2011年在我院住院行直接PCI的患者794例,根据是否患有糖尿病分为DM组(175例)与对照组(619例).通过观察两组临床特点、造影结果、术后心肌梗死溶栓试验(TIMI)血流及住院期间病死率评价预后.结果 与对照组相比,DM组患者年龄、高血压史、发病至就诊时间、术前TIMI血流0级、病变血管数、梗死相关动脉(IRA)开通时间、术后无复流或慢血流发生比例、住院期间病死率均增高,而男性比例、吸烟、左室射血分数、术后TIMI血流3级比例、ST段回落率均降低,两组间差异有统计学意义(均P＜0.05);Logistic回归分析显示:DM与直接PCI术后住院期间病死率有回归关系[OR=2.034,95%CI(0.976,3.988),P=0.031].结论 DM患者直接PCI术后心功能及组织灌注差,住院期间病死率高,应重视这些临床特点、加强监护、积极干预.%Objective To investigate the impact of diabetes mellitus ( DM ) on prognosis of patients with acute myo-cardial infarction ( AMI) who underwent primary percutaneous coronary intervention ( PCI ). Methods The data of 794 AMI patients undergoing PCI from 2010 to 2011 were analyzed retrospectively. The patients were divided into DM group ( n = 175 ), the others into control group ( n = 619 ). The clinical features, angiographic results, post - operative TIMI flow and hospital mortality were observed to evaluate prognosis. Results As compared with control group, age, hypertension, onset to treatment time, pre - operative TIMI flow 0 degree, number of diseased vessels, IRA - time, post - operative non - occurrence rate of re-flow or slow flow, hospital mortality increased, while the proportion of males, smoking, left ventricular ejection fraction, rate of post - operative TIMI flow 3 degree, ST segment drop rate decreased, the difference was significant ( P < 0. 05 ). Logistic regression analysis showed that DM was an independent risk factor influencing hospital mortality after PCI [ OR = 2. 034, 95% CI ( 0. 976, 3. 988 ), P=0. 031 ]. Conclusion Post -PCI heart function and tissue perfusion are poor and hospital mortality is high in DM patients. Attention should be paid to these clinical features, and cares and intervention be strengthened.
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