摘要
目的探讨老年糖尿病合并急性心肌梗死患者营养风险筛查结果及其与预后的关系。方法回顾性分析2019年3月~2021年3月在郴州市第一人民医院住院的160例急性心肌梗死患者的临床资料,根据患者是否合并糖尿病分为急性心肌梗死组(98例)和糖尿病合并急性心肌梗死组(62例)。比较两组患者的一般资料及总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FBG)、糖化血红蛋白(HbAlc)、肌钙蛋白I(cTnI)、营养风险筛查量表(NRS2002)评分,出院后随访1年,比较两组患者不良心血管事件的发生情况,分析血清指标及营养风险评分与预后的相关性,糖尿病合并急性心肌梗死患者预后的影响因素采取多因素logistic回归性分析明确。结果两组TC、TG、LDL-C、FBG比较差异无统计学意义(P>0.05),糖尿病合并急性心肌梗死组HDL-C显著低于急性心肌梗死组,HbAlc、cTnI、NRS2002评分显著高于急性心肌梗死组,差异有统计学意义(P<0.05);两组心源性死亡、心力衰竭、再发心肌梗死发生率比较差异无统计学意义(P>0.05),糖尿病合并急性心肌梗死组心律失常发生率显著高于急性心肌梗死组,差异有统计学意义(P<0.05);经相关性分析,HDL-C与糖尿病合并急性心肌梗死患者预后呈现负相关,HbAlc、cTnI、NRS2002评分与糖尿病合并急性心肌梗死患者预后呈现正相关,差异有统计学意义(P<0.05);经Logistic分析,HDL-C、HbAlc、cTnI、NRS2002评分是糖尿病合并急性心肌梗死患者预后的独立影响因素,差异有统计学意义(P<0.05)。结论老年糖尿病合并急性心肌梗死患者营养风险更高,HDL-C、HbAlc、cTnI、营养风险评分与患者预后具有相关性,是其独立影响因素,低HDL-C,高HbAlc、cTnI、营养风险评分的患者预后更差。
Objective To investigate the nutritional risk screening results and their relationship with prognosis in elderly diabetic patients with acute myocardial infarction.Methods The clinical data of 160 patients with acute myocardial infarction hospitalized in our hospital from March 2019 to March 2021 were retrospectively analyzed.According to whether the patients were complicated with diabetes,they were divided into acute myocardial infarction group(n=98)and diabetes with acute myocardial infarction group(n=62).The general data and scores of total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C),low density lipoprotein cholesterol(LDL-C),fasting blood glucose(FBG),glycosylated hemoglobin(HbAlc),troponin I(cTnI)and nutritional risk screening scale(NRS 2002)were compared between the two groups.The patients were followed up for 1 years after discharge to compare the incidence of adverse cardiovascular events between the two groups.The correlation between serum indexes and nutritional risk scores and prognosis was analyzed.The prognostic factors of diabetic patients with acute myocardial infarction were identified by multivariate Logistic regression analysis.Results There was no significant difference in TC,TG,LDL-C and FBG between the two groups(P>0.05).HDL-C in the group of diabetes with acute myocardial infarction was significantly lower than that in the group of acute myocardial infarction,HbAlc,cTnI and NRS 2002 scores were significantly higher than that in the group of acute myocardial infarction(P<0.05).There was no significant difference in the incidence of cardiac death,heart failure and recurrent myocardial infarction between the two groups(P>0.05).Correlation analysis showed that HDL-C was negatively correlated with the prognosis of diabetic patients with acute myocardial infarction,HbAlc,cTnI and NRS 2002 scores were positively correlated with the prognosis of diabetic patients with acute myocardial infarction,all P<0.05.Logistic analysis showed that HDL-C,HbAlc,cTnI and NRS2002 sc
作者
王璐
杨文斌
朱丽君
Wang Lu;Yang Wenbin;Zhu Lijun(Endocrinology,Chenzhou First People's Hospital,Chenzhou 423000,China)
出处
《中华保健医学杂志》
2022年第5期376-379,共4页
Chinese Journal of Health Care and Medicine
基金
湖南省郴州市科学技术局科技发展计划项目(zdyf201951)。
关键词
老年
糖尿病
急性心肌梗死
营养风险筛查
预后
Elderly
Diabetes
Acute myocardial infarction
Nutritional risk screening
Prognosis
