摘要
目的:研究小剂量阿司匹林对2型糖尿病病人非致死性心梗和脑梗一级预防的作用。方法:研究对象为2015年1月至2016年12月就诊于皖南医学院弋矶山医院内分泌科2次以上(住院间隔3个月以上)的40岁至90岁2型糖尿病患者,使用医院HIS系统查询病人门诊及住院档案,根据患者第一次就诊后1年内小剂量阿司匹林的使用情况将患者分为阿司匹林使用组及阿司匹林未使用组,并收集患者第一次就诊时的基本资料:姓名、性别、年龄、糖尿病病程、收缩压、舒张压,记录患者实验室指标包括:空腹血糖、糖化血红蛋白、甘油三脂、总胆固醇、低密度脂蛋白、高密度脂蛋白、肌酐、血小板等指标,并记录其就诊过程中是否有高血压、冠心病、房颤、高脂血症、糖尿病肾病、动脉硬化等并发症。使用卡方检验及Cox比例风险模型对比分析两组患者基线数据及第一次使用阿司匹林后5年内心脑血管疾病发病情况。结果:4176例患者中,2137例为2型糖尿病,417例符合入组条件,其中男性198例,女性219例,阿司匹林使用组为224例,非使用组为193例。与非使用组相比,阿司匹林使用组脑梗死发病率无明显差别(χ^(2)=0.820,P=0.365),非致死性心梗发病率低于阿司匹林非使用组(χ^(2)=10.099,P=0.01),而大出血事件发生率明显高于阿司匹林非使用组(χ^(2)=5.425,P=0.020)。在阿司匹林使用组的亚组分析中,<60岁的患者比≥60岁的患者缺血性脑卒中(脑梗死)发病率低,风险比为0.428(95%CI:0.255-0.719,P=0.001);与男性相比,女性患者脑梗死发病率较高,风险比为1.574(95%CI:1.018-2.434,P=0.041)。结论:在这项针对2型糖尿病患者的研究中,小剂量阿司匹林可以降低非致死性心梗的发病率,但对非致死性缺血性脑卒中的发病率无明显影响,且明显增加大出血事件的发生率,临床应慎重考虑应用小剂量阿司匹林作为2型糖尿病患者非致死性脑梗死
AIM:To investigate the effect of low-dose aspirin on primary prevention of non-fatal myocardial and cerebral infarction in patients with type 2 diabetes mellitus.METHODS:From January 2015 to December 2016,40-90 years old patients with type 2 diabetes were treated in the Department of Endocrinology of Yijishan Hospital of Wannan Medical College for more than 2 times(the interval of hospitalization was more than 3 months),we use the hospital’s his system to search out-patient and in-patient files,patients were divided into aspirin group and non-aspirin group according to the use of low-dose aspirin within 1 year after the first visit,the basic data of the first visit were collected:name,sex,age,course of diabetes,systolic and diastolic blood pressure,patients were recorded for laboratory markers including fasting blood glucose,glycated hemoglobin,triglyceride,total cholesterol,Low-density lipoprotein,high-density lipoprotein,creatinine,and platelets,complications such as hypertension,coronary heart disease,atrial fibrillation,hyperlipidemia,diabetic nephropathy and arteriosclerosis were recorded.A Chi square test and a Cox proportional hazard model were used to compare baseline data and cerebrovascular disease after the first use of aspirin.RESULTS:Of the 4176 patients,2137 were type 2 diabetes,417 were eligible for admission,including 198 males,219 females,224 aspirin users and 193 non-users.There was no significant difference in the incidence of cerebral infarction between the aspirin group and the non-aspirin group(χ^(2)=0.820,P=0.365).The incidence of non-fatal myocardial infarction was lower than that of the aspirin non-aspirin group(χ^(2)=10.099,P=0.01),the incidence of massive hemorrhage was significantly higher than that of aspirin-free group(χ^(2)=5.425,P=0.020).In a subgroup analysis of aspirin use,patients younger than 60 years of age had a lower incidence of ischemic stroke(cerebral infarction)and a risk ratio of 0.428(95%CI:0.255-0.719,P=0.001)compared with patients older than 60 years of age,the
作者
曾晓凡
许宜琪
刘书
吴茜
李自保
何俊俊
金岳龙
赵永莉
何春玲
高家林
ZENG Xiaofan;XU Yiqi;LIU Shu;WU Qian;LI Zibao;HE Junjun;JIN Yuelong;ZHAO Yongli;HE Chunling;GAO Jialin(Department of Endocrinology,Yijishan Hospital,Wannan Medical College,Wuhu 241001,Anhui,China;Department of Neurology,Yijishan Hospital,Wannan Medical College,Wuhu 241001,Anhui,China;Public Health Hospital of Wannan Medical College,Wuhu 241000,Anhui,China)
出处
《中国临床药理学与治疗学》
CAS
CSCD
2022年第6期665-671,共7页
Chinese Journal of Clinical Pharmacology and Therapeutics
基金
活性生物大分子研究安徽省重点实验室自主研究课题(LAB201808)
安徽省高等学校人文社会科学研究项目(SK2019A0214)
皖南医学院校级重点科研基金项目(WK2020Z02)
皖医弋矶山医院“高峰”培育计划(GF2019J07)
皖医弋矶山医院“攀峰”培育计划(PF2019013)
安徽省重点研究与开发计划(202104j07020023)。
