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目的探讨糖尿病与非糖尿病青年心肌梗死的不同之处。方法收集94例青年心肌梗死患者,分为糖尿病(DM)组和非糖尿病(。NDM)组,分析两组临床特点、冠状动脉造影结果、高危因素及预后的区别。结果DM组无典型胸痛(25.0%vs 7.6%)、非ST段抬高型心肌梗死(50.0%vs9.1%)、室壁运动异常(78.6%vs 42.4%)、双支病变(35.7%vs 21.2)、三支病变发生率(39.3%vs3.1%)、死亡率(10.7%vs 1.5%)均高于NDM组(P<0.05或P<0.01);DM组冠状动脉病变支数、冠状动脉病变积分(Gensini积分)分别为(2.110±0.875)支、(52.61±10.47)分;NDM组分别为(1.140±0.677)支、(34.02±10.24)分,两组间比较差异均有统计学意义(P<0.05)。经多元线性回归分析发现,HbA_1c、吸烟是Gensini积分的独立危险因素。结论糖尿病青年心肌梗死患者临床特点更复杂,冠状动脉病变更严重,预后更差;HbA_1c和吸烟与Gensini积分呈正相关。
Objective To explore the difference between myocardial infarction in diabetic and non-diabetic youth. Methods 94 cases of young myocardial infarction were collected and divided into diabetic group and non-diabetic group. The clinical characteristics, coronary angiography results, risk factors and prognosis of the two groups were analyzed. Results There was no typical chest pain in DM group (25.0% vs 7.6%), non-ST-segment elevation myocardial infarction (50.0% vs 9.1%), abnormal wall motion (78.6% vs 42.4% 21.2). The incidence of three lesions (39.3% vs 3.1%) and mortality (10.7% vs 1.5%) were significantly higher than those in NDM group (P <0.05 or P <0.01) (2.110 ± 0.875) and (52.61 ± 10.47) points respectively in arterial lesions and (1.140 ± 0.677) and (34.02 ± 10.24) points in NDM group, respectively, with statistical difference between the two groups Significance (P <0.05). Multivariate linear regression analysis showed that smoking was an independent risk factor for Gensini score. Conclusion The clinical features of diabetic young patients with myocardial infarction are more complicated, the severity of coronary artery disease is worse, and the prognosis is worse. HbA 1c and smoking are positively correlated with Gensini score.