老年T2DM合并亚临床甲状腺功能减退患者发生冠心病的危险因素分析

Risk Factors of Coronary Heart Disease in Elderly T2DM Patients with Subclinical Hypothyroidism

目的:研究老年2型糖尿病(T2DM)合并亚临床甲状腺功能减退(SCH)患者发生冠心病的危险因素分析。方法:回顾性分析2017年2月-2018年12月在笔者所在医院接受治疗的120例老年T2DM合并SCH患者作为研究组,另选取同期在笔者所在医院接受治疗的老年单纯T2DM患者120例作为对照组,比较两组患者冠心病发生率;按照研究组患者是否发生冠心病分为A组(有冠心病)和B组(无冠心病),比较两组患者基础临床资料、生化和甲状腺功能相关指标水平,并分析老年T2DM合并SCH患者发生冠心病的危险因素。结果:研究组患者冠心病发生率为48.33%,明显高于对照组的25.00%(P<0.05)。A组患者TSH、TG、24 h DBP和LDL-C水平明显高于B组,FT4和HDL-C水平明显低于B组,差异均有统计学意义(P<0.05)。TG、LDL-C、24 h DBP是老年T2DM合并SCH患者发生冠心病的独立危险因素(P<0.05)。结论:临床上应针对TSH、LDL-C、24 h DBP等老年T2DM合并SCH患者冠心病发生的危险因素采取相应措施,制定更为合适的治疗方案。

Objective:To study the risk factors of coronary heart disease in elderly patients with type 2 diabetes mellitus(T2DM)and subclinical hypothyroidism(SCH).Method:A retrospective analysis of 120 elderly T2DM patients with SCH who were treated in our hospital from February 2017 to December 2018 were conducted as the study group,and other 120 elderly simple T2DM patients who were treated in our hospital at the same time were selected as the control group.The incidence of coronary heart disease in the two groups was compared.According to whether coronary heart disease occurred in the study group,they were divided into group A(with coronary heart disease)and group B(without coronary heart disease).The basic clinical data,biochemical and thyroid function indexes of the two groups were compared and analyzed.The risk factors of coronary heart disease in elderly T2DM patients with SCH were analyzed.Result:The incidence of coronary heart disease in the study group was 48.33%,significantly higher than 25.00%in the control group(P<0.05).The levels of TSH,TG,24 h DBP and LDL-C in group A were significantly higher than those in group B,and the levels of FT4 and HDL-C were significantly lower than those in group B(P<0.05).TG,LDL-C and 24 h DBP were independent risk factors of coronary heart disease in elderly patients with T2DM and SCH(P<0.05).Conclusion:In clinic,we should take corresponding measures for the risk factors of coronary heart disease in the elderly T2DM patients with SCH,such as TSH,LDL-C and 24 h DBP,and develop a more appropriate treatment plan.