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目的探讨空腹高血糖对急性心肌梗死(AMI)患者近期心血管事件的预测价值。方法入选2010年2月至2013年2月我院诊治的AMI患者183例,根据入院时空腹血糖(FBG)水平分为FBG正常组(90例)与FBG升高组(93例),FBG正常组FBG<6.0 mmol/L,FBG升高组FBG≥6.0 mmol/L。记录两组患者一般临床资料及近期主要不良心血管事件(MACE)发生情况。采用多因素Logistic回归法分析FBS是否为影响AMI近期MACE发生的因素,Kaplan-Meier生存曲线分析FBG水平与近期预后的关系。结果入院时除FBG外,患者其他临床基线资料差异无统计学意义(P>0.05);住院及18个月随访期间FBG升高组MACE发生率明显高于FBG正常组(P<0.05);多因素Logistic回归分析表明FBG升高是AMI患者近期发生新发或再发心肌梗死(OR=1.121,P=0.003)、心肌梗死后心绞痛(OR=1.094,P=0.036)、充血性心力衰竭(OR=1.066,P=0.011)、严重心律失常(OR=1.081,P=0.023)、心源性休克(OR=1.103,P=0.037)、心源性死亡(OR=1.077,P=0.026)的独立危险因子;Kaplan-Meier生存曲线分析显示,AMI患者近期MACE发生率随FBG水平升高而明显增加,FBG水平越高近期预后越差(P=0.001)。结论空腹高血糖是AMI患者近期MACE的独立预测因素,近期心血管事件发生率随着FBG水平升高而显著增加。
Objective To investigate the predictive value of fasting hyperglycemia in recent cardiovascular events in patients with acute myocardial infarction (AMI). Methods A total of 183 AMI patients admitted to our hospital from February 2010 to February 2013 were divided into two groups according to their FBG levels: normal FBG group (n = 90) and elevated FBG group (n = 93), FBG was normal Group FBG <6.0 mmol / L, FBG elevated group FBG ≥ 6.0 mmol / L. The general clinical data of two groups and the recent occurrence of major adverse cardiovascular events (MACE) were recorded. Multivariate logistic regression analysis was used to analyze whether FBS was the factor influencing recent MACE in AMI. The Kaplan-Meier survival curve was used to analyze the relationship between FBG level and the prognosis. Results There was no significant difference in other clinical baseline data except for FBG at admission (P> 0.05). The incidence of MACE in hospitalized patients and FBG increased group was significantly higher than that in FBG normal group (P <0.05) Factors Logistic regression analysis showed that elevated FBG was associated with new or recurrent myocardial infarction (OR = 1.121, P = 0.003), myocardial infarction angina (OR = 1.094, P = 0.036), congestive heart failure (OR = 1.081, P = 0.011), severe arrhythmia (OR = 1.081, P = 0.023), cardiogenic shock Risk factors; Kaplan-Meier survival curve analysis showed that the incidence of MACE in patients with AMI was significantly increased with the increase of FBG level. The higher the level of FBG, the worse the prognosis (P = 0.001). Conclusion Fasting hyperglycemia is an independent predictor of recent MACE in patients with AMI. The recent incidence of cardiovascular events increased significantly with the increase of FBG levels.