目的 探讨老年2型糖尿病（type2diabetesmellitus，T2-DM）并发急性心肌梗死（acutemyocardialinfarction，AMI）的临床特点。方法对2008-02至2011-03住院的60岁以上老年2型糖尿病并发AMI接受冠脉造影（coronaryarteriography，CAG）的糖尿病组43例患者，与同期非糖尿病AMI接受冠脉造影的非糖尿病组51例老年患者的临床表现、冠脉特点进行对比分析。结果糖尿病组血糖（12.9±5.2）mmol/L高于非糖尿病组（5.11±0.65）mmol/L(P＜0.05）。糖尿病组发病至入院时间平均（46±32）h，非糖尿病组平均（12±7）h，P＜0.01。糖尿病组不典型胸痛22例（51%）、无胸痛12例（28%），非糖尿病组分别为9例（18%）、3例（6%），（P＜0.01）。糖尿病组冠状动脉Ⅲ度狭窄20例（46.5%）、Ⅳ度狭窄11例（25.6%），非糖尿病组分别为11例（21.6%）和4例（7.8%），（P＜0.01）。糖尿病组患者住院4周病死8例（18.6%），非糖尿病组3例（5.9%），（P＜0.05）。结论老年2型糖尿病并发AMI因症状不典型或无症状，使得入院时间延长。血糖高，病死率高，并发症多，心功能差，冠脉病变程度重是老年2型糖尿病并发AMI的临床特点。

Objective To study the clinical characteristics of senile type 2 diabetes mellitus(T2-DM) with concurrent acute myocardial infarction (AMI). MethodsNinety-four patients, over 60 years old and hospitalized from February 2008 to March 2011, were slividced into two groups: (1) Group A consisted of 51 patients with type 2 diabetes mellitus and concurrent acute myocardial infarction who received coronary arteriography (CAG). (2) Group B consisted of 51 patients without T2-DM who received CAG. The clinical manifestations and the coronary artery characteristics in both groups were analyzed and compared. ResultsBlood sugar in group A was （12.9±5.2） mmol/L and was （5.11±0.65） mmol/L (P<0.05)in group B.The average time from the onset to hospitalization was （46±32） hour for group A, and （12±7） hours for group B (P<0.01). In group A, 22(51%) had atypical chest pain and 12(28%) had non-chest pain while in group B, there were 9(18%) and 3 cases (6%), respectively (P<0.01). Group A had coronary artery degree Ⅲ narrowing in 20(46.5%) and degree Ⅳ narrowing in 11(25.6%) while in group B there were 11(21.6%) and 4 cases (7.8%) respectively (P<0.01). Eight patients in group A died (18.6%) after 4 weeks of hospitalization and  3 patients (5.9%) in group B(P<0.05). ConclusionsIn elder patients with T2-DM and concurrent AMI, the atypical symptoms or lack of symptoms can cause delayed hospitalization. Their blood sugar level and fatality rate are high, complications are numerous, cardiac function is bad, and pathological changes in coronary arteries are severe.