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目的探讨急性心肌梗死早期不同糖代谢状态冠状动脉病变和介入治疗的差异。方法对连续99例既往无糖尿病史的急性心肌梗死患者进行动态血糖监测,比较不同糖代谢状态患者选择性冠状动脉造影和介入治疗情况。结果持续性血糖升高患者较血糖正常组和一过性血糖升高组三支病变比例(χ2=28.75,P<0.01)、动脉钙化病变(χ2=4.21,P<0.05)和长病变(χ2=4.01,P<0.05)比例以及Gensini积分在Q3(χ2=5.18,P<0.05)以及Q4(χ2=9.672,P<0.01)范围内的比例均显著升高、PCI术成功率显著降低(χ2=6.91,P<0.05)。结论心梗后早期持续性血糖升高患者冠状动脉病变最为严重,且介入治疗成功率低。
Objective To investigate the differences of coronary artery lesions and interventional therapy in different glycometabolic states early after acute myocardial infarction. Methods A total of 99 consecutive patients with acute myocardial infarction without previous diabetes mellitus were enrolled in the study. Dynamic coronary glucose monitoring was performed to compare coronary artery angiography and interventional therapy in patients with different glycometabolism status. Results Compared with the patients with persistent hyperglycemia, the ratio of three lesions (χ2 = 28.75, P <0.01), arterial calcification (χ2 = 4.21, P <0.05) and long lesions = 4.01, P <0.05), and the proportion of Gensini scores in Q3 (χ2 = 5.18, P <0.05) and Q4 (χ2 = 9.672, P <0.01) were significantly increased = 6.91, P <0.05). Conclusions The patients with persistent hyperglycemia in the early post-MI period have the most severe coronary lesions and the low success rate of interventional therapy.