2型糖尿病病人急性心肌梗死危险因素的病例-对照研究

A case-control Study of Risk Factors for Type 2 Diabetes Mellitus Patients with Acute Myocardial Infarction

目的通过回顾性病例-对照研究,分析2型糖尿病人急性心肌梗死的危险因素。方法选择在娄底市3家医院出院诊断为2型糖尿病人1137例,以合并急性心肌梗死者72例作为病例组,无合并急性心肌梗死者1065例作为对照组,比较两组间危险因素的差异。结果住院2型糖尿病人急性心肌梗死的患病率6.33%。多因素Logistic分析显示,控制血糖用药不规则(OR1.78,95%可信区间1.07～2.97)、血糖控制欠佳(OR1.89,95%可信区间1.15～3.11)、高血压(OR1.68,95%可信区间1.01～2.81)、甘油三酯≥2.82mmol/L(OR2.26,95%可信区间1.37～3.72)、体质指数≥25kg/m2(OR1.79,95%可信区间1.06～3.02)是2型糖尿病人急性心肌梗死的独立危险因素。结论血糖控制欠佳、用药不规则、高血压、高甘油三酯血症、肥胖等因素的控制对预防2型糖尿病人的急性心肌梗死具有重要意义。

Objective To identify the risk factors for type 2 diabetes mellitus patients(DM) with acute myocardial infarction(AMI). Methods A Total of 1 137 patients with DM was collected from 3 hospitals over a 4-year period. A case-control study was conducted on the date of the patients having DM with and without AMI. The effect of each variable on AMI was assessed with a logistic regression analysis. Results Among the studied DM patients, 72 (6.33%) had AMI .In multivariate analysis, abnormity use of drugs for blood glucose control (OR=1.78, 95%CI 1.07～2.97), lack of well control of blood sugar (1.89, 1.15～3.11), hypertension (1.68, 1.01～2.81), TG≥2.82 mmol/L(2.26, 1.37～3.72), BMI≥25 kg/m2 (1.79, 1.06～3.02) were independently associated with AMI. Conclusion The results suggested that irregular drug use for blood sugar control, lack of well control of blood sugar, hypertension, TG≥2.82 mmol/L and BMI≥25 kg/m2 were independent risk factors for DM with AMI, the above factors under control might play a role in preventing AMI in DM.