中老年糖尿病合并高血压患者心脑血管事件发生情况分析

Cardiovascular and cerebrovascular events in middle and old age patients suffering from diabetes mellitus complicated with hypertension

目的分析中老年糖尿病合并高血压患者心脑血管事件发生情况。方法选择2010年1月至2014年12月于北京积水潭医院就诊的中老年糖尿病和高血压患者1125例作为观察组。根据疾病类型的不同，将患者分为糖尿病组（358例）、高血压组（401例）和糖尿病合并高血压组（366例）。选择同期本院体格检查的376名受试者作为对照组。分析中老年糖尿病合并高血压患者心脑血管事件和全因死亡发生情况。结果随访5年后，总心脑血管事件91例，全因死亡35例。观察组心脑血管事件86例，对照组心脑血管事件5例；观察组全因死亡31例，对照组全因死亡4例。经过Log—rank法检验，观察组心肌梗死、脑梗死、脑出血、心脑血管事件、全因死亡发生率明显高于对照组[2．0％（23／1125）比0．3％（1／376）、3．7％（42／1125）比0．8％（3／376）、1．9％（21／1125）比0．3％（1／376）、7．6％（86／1125）比1．3％（5／376）、2．8％（31／1125）比1．1％（4／376）]；糖尿病合并高血压组心脑血管事件和全因死亡发生率明显高于对照组、糖尿病组和高血压组[12．6％（46／366）比1．3％（5／376）、6．7％（24／358）、4．0％（16／401）；4．1％（15／366）比1．1％（4／376）、2．8％（10／358）、1．5％（6／401）]，差异均有统计学意义（均P〈0．05）。结论中老年糖尿病合并高血压患者心脑血管事件和全因死亡发生率明显高于糖尿病、高血压患者和对照组受试者；此外，糖尿病患者心肌梗死和脑梗死发生率高于高血压患者，而脑出血发生率低于高血压患者。

Objective To analyze the incidence of cardiovascular and cerebrovascular events in middle and old age patients suffering from diabetes complicated with hypertension. Methods Totally 1 125 middle and old age patients with diabetes and hypertension from January 2010 to December 2014 in Beijing Jishuitan Hospital were enrolled as observation group; they were divided into diabetes group （358 cases ）, hypertension group （401 cases） and diabetes complicated with hypertension group （366 cases）. A total of 376 physical examination people were enrolled as control group. The incidence of cardio-cerebrovascular events and all-cause mortality were analyzed. Results During 5-year follow-up, there were 91 cases of cardio-cerebrovascular events and 35 cases of all-cause death in total. The observation group had 86 cases of cardio-cerebrovascular events and 31 cases of all-cause death. The control group had 5 cases of cardio-cerebrovascular events and 4 cases of all-cause death. Log-rank test showed that incidences of myocardial infarction, cerebral infarction, cerebral hemorrhage, total cardio-cerebrovascular events and the all-cause mortality in observation group were significantly higher than those in control group[2.0% （23/1 125） vs 0. 3% （ 1/376）, 3.7% （42/1 125） vs 0. 8% （3/376）, 1.9% （21/1 125） vs 0.3% （1/376）, 7.6% （86/1 125） vs 1.3% （5/376）, 2.8% （31/1 125） vs 1.1% （4/376） ~ （P 〈0.05）. Incidences of cardio-cerebrovascular events and all-cause mortality in diabetes complicated with hypertension group were significantly higher than those in control group, diabetes group and hypertension group [ 12. 6% （46/366） vs 1.3% （5/376）, 6. 7% （24/358）, 4. 0% （ 16/401 ） ; 4. 1% （15/366） vs 1.1% （4/376）, 2. 8% （ 10/358）, 1.5% （6/401）] （P 〈 0.05）. Conclusion Middle and old age patients suffering from diabetes complicated with hypertension have high incidence of cardio-cerebrovascular events and high all-cause mortality; incidences of myocardial infarction and cerebral infarction in patients with diabetes are higher than those in patients with hypertension ; the incidence of cerebral hemorrhage in patients with hypertension is higher than that in patients with diabetes.