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糖尿病是冠心病重要的危险因素,并于2004年被美国心脏病学会正式定义为冠心病的等危症。糖尿病可以使冠心病的发病率增加2～3倍,对于严重的糖尿病患者如果遭遇心肌缺血的打击,其更加容易发生心力衰竭和死亡,拥有明显更差的预后,一系列研究显示糖尿病患者发生急性心肌梗死后,将有20%～35%合并心力衰竭,相对于非糖尿病患者发生率增加2～4倍。越来越多的医生开始认识到问题的严重性,然而我国临床实践中急性心肌梗死患者的血糖管理目前尚无统一的规范,大型临床试验的治疗靶点和治疗目标均不统一,现将结合欧洲心血管疾病和糖尿病联合指南以及阜外医院的临床经验详细阐述。
Diabetes is an important risk factor for coronary heart disease and was formally defined as an equal risk of coronary heart disease by the American College of Cardiology in 2004. Diabetes can increase the incidence of coronary heart disease by 2 to 3 times, for patients with severe diabetes hit myocardial ischemia, which is more prone to heart failure and death, has a significantly worse prognosis, a series of studies have shown that patients with diabetes After acute myocardial infarction, there will be 20% to 35% of patients with heart failure, relative to the non-diabetic patients increased by 2 to 4 times. More and more doctors are beginning to recognize the seriousness of the problem. However, there is no uniform standard for the management of blood glucose in patients with acute myocardial infarction in clinical practice in our country. The therapeutic targets and treatment targets of large-scale clinical trials are not uniform. European guidelines for cardiovascular disease and diabetes and Fu Wai Hospital clinical experience elaborated.