摘要
目的探讨2型糖尿病（T2DM）合并冠心痛（CHD）患者的临床特点及相关危险因素。方法选取2016年4月至11月电子病历中确诊的T2DM患者4800例，根据是否合并CHD分为单纯T2DM组（n=4331）和T2DM合并CHD组（n=469）。比较两组一般临床资料及实验室数据的差异，并用二元logistic回归方法分析CHD与相关危险因素的相关性。结果T2DM合并CHD组患者年龄、体质指数（BMI）、腰围、糖尿病病程、低密度脂蛋白（LDL）、餐后2h血糖（2hPPG）、高血压比例、使用他汀类和血管紧张素转换酶抑制剂CACED比例高于单纯T2DM组，差异均有统计学意义（P〈0．05）；二分类单因素Logistic回归分析显示，年龄、BMI、糖尿病病程、LDL、2hPPG的比值比（OR）〉1．0（P〈0．05），CHD与上述因素呈正相关为CHD危险因素；高血压、他汀类、ACEI的OR〈1．0（P〈005），为CHD保护N素；二分类多因素Logistic回归分析LDL、BMI、年龄、2hPPG与糖尿病病程为CHD的独立相关危险因素，其中LDL是最显著的危险因素（OR=1．408．95％CI=1．258～1577）。使用ACEI为CHD的保护因素，与未使用ACEI的人群相比，使用ACEI可降低52％的CHD发病风险（OR=0480．95％CI=0325～0．709）。结论LDL、BMI、年龄、2hPPG与糖尿病病程可增加T，DM合并CHD的发生风险，ACEI为T2DM合并CHD保护因素。应开展针对性的人群预防，加强糖尿病合并CHD危险因素的综合防治，对提高糖尿病合并CHD的生活质量和改善预后有着重要意义。
Objective To study the risk factors for coronary heart disease （ CHD ） in patients with type 2 diabetes mellitus （ T2DM ） . Methods A total of 4800 patients with type 2 diabetes diagnosed at Endocrinology Departments from April 2016 to November 2016 were selected and divided into T2DM only group （ n=4331 ） and T2DM with CHD group （ n=469 ） according to whether or not CHD. The clinical data and laboratory data were compared between two groups. Logistic regression method was used to analyze the correlation between coronary heart disease and related risk factors. Results The age, BMI, waist circumference, duration of diabetes mellitus, LDL, 2hPPG, hypertension ratio, the proportion of using statin and angiotensin converting enzyme inhibitors were significantly higher in T2DM with CHD group than T2DM only group （ P〈0.05 ） . The single factorial logistic regression analysis showed that there was a positive correlation between CHD and advanced age, BMI, duration of diabetes mellitus, LDL and 2hPPG （OR〉0.1, P〈0.05 ） , whereas hypertension, statin and angiotensin converting enzyme inhibitors were the protective factors of CHD （ OR〈1.0, P〈0.05 ） . By muhivariable logistic regression analysis, LDL, BMI, age, 2hPPG and duration of diabetes mellitus were independent risk factors in T2DM with CHD, of which LDL was the most important risk factors （ OR= 1.408, 95%CI=1.258～1.577, P〈0.001 ） . The use of angiotensin converting enzyme inhibitors was a protective factor for CHD. Angiotensin converting enzyme inhibitors reduced the risk of CHD by 52%, compared to those who did not use angiotensin-converting enzyme inhibitors （ OR=0.480, 95%CI=0.325 to 0.709 ） . Conclusion LDL, BMI, age, 2hPPG and diabetes mellitus can increase the risk of T2DM with CHD, angiotensin converting enzyme inhibitors can be seen as protection factors for CHD. It us important to carry out targeted population prevention and strengthen treatment of risk factors of T2DM with CHD, thereby improving the quality of
出处
《浙江临床医学》
2018年第8期1400-1402,共3页
Zhejiang Clinical Medical Journal
关键词
2型糖尿病
冠心病
危险因素
Type 2 diabetes mellitus
Coronary heart disease
Risk factors
