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糖尿病对心肌梗死患者临床实验室特征及院内临床结局的影响。

Impact of diabetes mellitus on clinico-laboratory characteristics and in-hospital clinical outcomes among patients with myocardial infarction.

作者信息

Khalid Syed Haroon, Liaqat Iqra, Mallhi Tauqeer Hussain, Khan Amer Hayat, Ahmad Junaid, Khan Yusra Habib

机构信息

Department of Pharmaceutics, Government College University, Faisalabad, Pakistan.

Faisalabad Institute of Cardiology FIC, Civil Lines, Faisalabad, Pakistan.

出版信息

J Pak Med Assoc. 2020 Dec;70(12(B)):2376-2382. doi: 10.47391/JPMA.370.

Abstract

OBJECTIVE

Diabetes mellitus (DM) along with myocardial infarction (MI) carries increased burden on patients in terms of morbidity, mortality and cost. Current study was aimed to investigate the impact of DM on clinico-laboratory characteristics on in-hospital treatment outcomes among MI patients.o compare the outcome of mesh hernioplasty performed under local anaesthesia in relatively young and older patients regarding wound complications and urinary retention.

METHODS

All MI patients admitted to the emergency department of Faisalabad Institute of Cardiology from April, 2016 to March, 2017 were recruited into the study. The clinico-laboratory profile and in-hospital outcomes of patients with and without DM were compared using chi-squared test or student t-test, where appropriate.

RESULTS

A total 4063 patients (Mean age: 55.86 ± 12.37years) with male preponderance were included into the study. STEMI was most prevalent (n = 2723, 67%) type of MI among study participants. DM was present in substantial number of cases (n = 3688, 90.8%). Patients with DM presented with increased BMI, higher blood pressure, elevated levels of cholesterol, serum creatinine, and blood urea nitrogen, when compared to the patients without DM (p<0.05). Out of 560 patients who were followed up, cardiogenic shock was frequent (n = 293, 52.3%) adverse outcome followed by heart failure (n = 114, 20.4%), atrial fibrillation (n = 78, 13.9%) and stroke (n = 75, 13.4 %). Moreover, in-hospital adverse outcomes were more prevalent among MI patients with DM than those without DM.

CONCLUSIONS

MI patients with DM present with varying clinico laboratory characteristics as well as experience higher prevalence of adverse cardiovascular events as compared to patients without DM. These patients require individual management strategy on very first day of admission.

摘要

目的

糖尿病(DM)与心肌梗死(MI)一起,在发病率、死亡率和成本方面给患者带来了更大的负担。当前研究旨在调查DM对MI患者临床实验室特征及住院治疗结局的影响。比较在相对年轻和年长患者中,局部麻醉下进行的疝修补术在伤口并发症和尿潴留方面的结局。

方法

招募2016年4月至2017年3月期间入住费萨拉巴德心脏病学研究所急诊科的所有MI患者。在适当情况下,使用卡方检验或学生t检验比较有和没有DM的患者的临床实验室资料和住院结局。

结果

共4063例患者(平均年龄:55.86±12.37岁)纳入研究,男性居多。ST段抬高型心肌梗死(STEMI)是研究参与者中最常见的MI类型(n = 2723,67%)。大量病例存在DM(n = 3688,90.8%)。与没有DM的患者相比,有DM的患者BMI增加、血压更高、胆固醇、血清肌酐和血尿素氮水平升高(p<0.05)。在560例接受随访的患者中,心源性休克是常见的(n = 293,52.3%)不良结局,其次是心力衰竭(n = 114,20.4%)、心房颤动(n = 78,13.9%)和中风(n = 75,13.4%)。此外,有DM的MI患者住院不良结局比没有DM的患者更普遍。

结论

与没有DM的患者相比,有DM的MI患者具有不同的临床实验室特征,并且不良心血管事件的发生率更高。这些患者在入院第一天就需要个性化的管理策略。

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