| Objective Many studies indicate that serum total cholesterol (TC) and low-density lipoprotein - cholesterol (LDL-C) is the major risk factors can interfere for atherosclerotic disease and the clinical symptoms. The high level of Serum total cholesterol is the major risk factors that caused atherosclerosis (AS). Low density lipoprotein - cholesterol increases positively correlated with the incidence of coronary heart disease. The prevalence of diabetes increases, and lipid metabolism disorder is the important risk factors for diabetes patients suffering from coronary heart disease. Diabetes patient's lipid metabolism disorders often presents with high level triglycerides (TG) and low level high-density lipoprotein cholesterol (HDL-C).The consistence of LDL - C are usually similar in diabetes or non diabetes patients, but the values of high-density lipoprotein (HDL) cholesterol are usually higher in diabetes patients. It is reported that almost 72.3% global diabetes patients suffered coronary heart disease. The prevalence of diabetes concurrent coronary heart disease than non-diabetic crowd for 2-4 times. It is revealing that diabetes patients with coronary artery disease have poor prognosis. It was unclear for the differences lipids level in the early phase of acute myocardial infarction (AMI) with or without diabetes mellitus, and the relevant reported little in the domestic. This study through detected serum lipid levels in the early phase of AMI, discusses the characteristics of its change. This dissertation conducts a retrospective analysis on the lipid level in acute myocardial infarction patients, among to find the different lipid levels among 2 groups, namely, AMI with diabetes mellitus, AMI without diabetes mellitus, in order to offer basic evidences for the prevention, diagnosis and treatment of AMI.Methods It conducts a retrospective study of 318 acute myocardial infarction (AMI) patients hospitalized in cardiovascular department of The Military General Hospital of Beijing from January 1, 2006 to March 31, 2007. The definition of acute myocardial infarction also adopts the same content with Universal Definition of Myocardial Infarction, the new diagnosis standard recommended by domestic experts. The diagnosis definition of diabetes mellitus adopts The American diabetes association announced diabetes diagnosis standard. The patients be classified into 2 groups, namely, AMI with diabetes mellitus (80 cases), AMI without diabetes mellitus(238 cases). at the next day morning ,All of patients'fasting blood samples are taken and sent to Clinical Laboratory for such ApoA ApoB, LP(a), TC, TG, HDL-C, LDL-C, blood routine and homeostasis; then, record the general clinical data, for example, gender, age smoking hypertension, and so on.Results:1 lipids level:1.1 TC No statically significant difference is found between 2 Groups. (P>0.05) 1.2 TG No statically significant difference is found between 2 Groups. (P>0.05)1.3 HDL-C No statically significant difference is found between 2 Groups. (P>0.05)1.4 LDL-C No statically significant difference is found between 2 Groups. (P>0.05)1.5 apoA The apparent differences are found between the 2 groups, the level of AMI with diabetes mellitus lower than AMI without diabetes mellitus.1.6 apoB No statically significant difference is found between 2 Groups. (P>0.05)2 White Blood Cell (WBC) and Neutrophils ratio are not statically significant difference is found between 2 Groups, but both the level of two groups are higher than normal.3 The Gensini scores have apparent difference between the 2 groups in circumflex branch of coronary artery. The narrow degree in AMI with diabetes mellitus badly than AMI without diabetes mellitus.Conclusion:1. AMI with or without diabetes mellitus, in the early period of AMI, the lipids (TC,TG,LDL-C,HDL-C,apoB) level are not significant difference between 2 groups; The apparent differences are found in apoA between the 2 groups, the level of AMI with diabetes mellitus lower than AMI without diabetes mellitus. In the early period of AMI, HDL and apoA make up acute phase of high density lipoprotein after HDL is back modified, thus affecting the intracellular cholesterol outflow, and the emergence of apoA reduced. This research also indicate that an acute inflammation may be when the acute myocardial infarction apoA and HDL-C decreased obviously, one of the likely cause of the lipid adjusting treatment standards should be further reduced, specific standard needs further research ..2. White Blood Cell (WBC) and Neutrophils ratio are not statically significant difference is found between 2 Groups, but both the level of two groups are higher than normal. It is indicated that the period of AMI occurred acute inflammatory reaction.3. The Gensini scores have apparent difference between the 2 groups in circumflex branch of coronary artery. The narrow degree in AMI with diabetes mellitus badly than AMI without diabetes mellitus. It is revealing that diabetes patients with coronary artery disease have poor prognosis. |
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