摘要
目的探索糖尿病心脏自主神经病变(DCAN)患者非心脏手术围术期心血管事件的危险因素。方法选择2020年1月至2021年4月入住我院需要行非心脏手术的DCAN患者200例。根据围术期是否发生心血管事件(PCE)分为PCE组(77例)和NPCE组(123例)。收集并比较两组患者的临床基本资料,合并症情况;血液生化指标,术中因素(麻醉方式、麻醉时间、手术分级、手术时间)。通过logistic回归方程分析DCAN患者心血管事件危险因素。结果PCE组和NPCE组在年龄、ASA分级、NYHA分级、糖尿病合并症、空腹血糖、糖化血红蛋白、微量白蛋白尿、麻醉时间、手术分级、手术时间方面存在显著差异(P<0.05)。多因素分析表明年龄大,ASA分级和NYHA分级高,合并有冠心病、心衰疾病,空腹血糖、糖化血红蛋白和微量白蛋白尿高,麻醉时间长,手术分级高,手术时间长是DCAN患者非心脏手术围术期心血管事件发生的危险因素。结论DCAN患者围术期心血管事件可能与年龄、ASA分级、NYHA分级、合并症情况、空腹血糖、糖化血红蛋白、微量白蛋白尿、麻醉时间、手术分级,手术时间密切相关,是其独立危险因素。
Objective To explore the risk factors of perioperative cardiovascular event in patients with diabetes cardiac autonomic neuropathy(DCAN)undergoing noncardiac surgery.Methods 200 patients with DCAN who were admitted to our hospital from January 2020 to April 2021 and needed non cardiac surgery were selected.The patients were divided into PCE group(77cases)and NPCE group(123cases)according to the perioperative cardiovascular events(PCE).Col ect and compare the basic clinical data,comorbidities,blood biochemical indicators,intraoperative factors(anesthetic mode,anesthetic time,surgical grade,surgical time)of the two groups.The risk factors of perioperative cardiovascular events in patients with DCAN undergoing non cardiac surgery were analyzed by logistic regression equation.Results There were significant differences between PCE group and NPCE group in age,ASA grade,NYHA grade,diabetes comorbidities,fasting blood glucose,glycosylated hemoglobin,microalbuminuria,anesthesia time,operation grade and operation time(P<0.05).Multivariate logistic regression analysis showed that older age,higher ASA grade and NYHA grade,combined with coronary heart disease,heart failure,high fasting blood glucose,glycosylated hemoglobin and microalbuminuria,long duration of anesthesia,high surgical grade,and long duration of surgery were the risk factors for the occurrence of cardiovascular events in DCAN patients during the perioperative period of non cardiac surgery.Conclusion Perioperative cardiovascular events in patients with DCAN may be closely related to age,ASA grade,NYHA grade,complications,fasting blood glucose,glycosylated hemoglobin,microalbuminuria,anesthesia time,operation grade,and operation time,which are independent risk factors.
作者
司建洛
杨木强
张洪军
麻黎斯
SI Jian-luo;YANG Mu-qiang;ZHANG Hong-jun;Ma Li-si(Department of Anesthesiology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471003,Henan Province,China)
出处
《罕少疾病杂志》
2023年第2期41-42,共2页
Journal of Rare and Uncommon Diseases
基金
河南省医学科技攻关计划(联合共建)项目(LHGJ20190572)。
关键词
糖尿病心脏自主神经病变
非心脏手术围术期
心血管事件
危险因素
Diabetes
Cardiac Autonomic Neuropathy
Perioperative Period of Non Cardiac Surgery
Cardiovascular Events
Risk Factors
