初诊2型糖尿病患者应用阿司匹林的现状调查

A Survey on the Aspirin Application in Type 2 Diabete Patients

目的 调查初诊2型糖尿病患者合并心血管危险因素及应用阿司匹林进行一级预防的现状,以及影响患者预防治疗的因素.方法 对我院2007-2010年初诊2型糖尿病患者按〈中国2型糖尿病防治指南〉建议的心血管危险因素进行调查,分析不同危险因素与服用阿司匹林的相关性,以Logistic回归方法筛选影响患者治疗的因素.结果 合计调查2850例患者,合并年龄大于40岁、血脂异常、家族史、高血压、吸烟、蛋白尿等危险因素的患者分别占94.4%、23.2%、24.6%、40.4%、9.1%和3.2%,共有680例患者（23.9%）应用阿司匹林进行预防治疗,其合并以下危险因素的比例显著高于未预防治疗的患者：年龄大于40岁、血脂异常、高血压、蛋白尿.Logistic回归分析发现年龄、血脂异常、高血压是促进患者服用阿司匹林的因素,其相对风险度分别是1.031、3.529和2.748.结论 2型糖尿病患者合并心血管危险因素非常常见,但应用阿司匹林进行一级预防的情况不容乐观,血脂异常和高血压是促使患者应用阿司匹林预防治疗的最重要因素.

Objective To investigate the status of type 2 diabete patients complicated with eadiovascular risk factors and the application of aspirin in these patients for primary prevention, and to analyze the factors associated with the management. Methods To survey the cadiovascular risk factors in the diabete patients of our endocrinology department. Association analysis was performed to analyze the relationship between different risk factor and management of aspirin. At last logistic regression analysis was performed to screen the risk factors which iniluenee aspirin therapy in patients. Result In total 2850 patients; there were 94.4%, 23.2%, 24.6%, 40.4%, 9.1% and 3.2% of patients complicated with more than 40 years, abnormal blood lipid, family history of cadiovaseular events, smoking and urine protein, respectively. Six hundred and eighty patients （23.9%） applied aspirin for primary prevention of eadiovaseular diseases. The proportions of the listed factors in patients with aspirin prevention were significantly higher than those in patients without aspirin prevention： more than 40 yrs, abnormal blood lipid, hypertension and urine protein. Logistic regression analysis showed that age, abnormal blood lipid and hypertension were promotive factors of aspirin application with odds ratio of 1.031, 3.529 and 2.748, respetively. Conclusion It was very common for type 2 diabete patients to complicate with eadiovaseular risk factors. Yet the application of aspirin for primary prevention on cardioveseular diseases was not optimistic. The risk factors of abnormal blood lipid and hypertension were the most important factors which promoted patients to use aspirin.