高血压合并T2DM患者大血管病变的影响因素分析

Analysis on the influencing factors of macrovascular disease in the patients with hypertension complicated with T2DM

目的探讨高血压合并2型糖尿病(T2DM)患者大血管病变的影响因素。方法回顾性分析南昌市第三医院2018年1月~2019年12月收治的200例高血压合并T2DM患者临床病历资料,根据是否发生大血管病变分为大血管病变组(MA组)和无大血管病变组(非MA组)。收集两组临床病历资料,找出高血压合并T2DM患者发生大血管病变的影响因素,并进行多因素分析。结果单因素分析显示,T2DM病程、吸烟、收缩压(SBP)、空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbAlc)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)可能是高血压合并T2DM患者发生大血管病变的影响因素(P<0.05);经多因素Logistic回归分析,T2DM病程、吸烟、SBP、FPG、2 hPG、Hb Alc、TG、LDL-C可使高血压合并T2DM患者发生大血管病变的危险增加2.915(1.575~5.393)倍、3.013(1.501~6.048)倍、1.862(1.024~3.387)倍、4.354(2.108~8.992)倍、1.984(1.073~3.668)倍、2.048(1.123~3.734)倍、1.965(1.068~3.618)倍、1.926(1.057~3.509)倍。结论T2DM病程、吸烟、SBP、FPG、2 hPG、HbAlc、TG、LDL-C是高血压合并T2DM患者发生大血管病变的独立危险因素,故积极控制患者血压、血糖、改善饮食、加强戒烟管理对预防高血压合并T2DM患者发生大血管病变具有重要意义。

Objective To explore the influencing factors of macrovascular disease in the patients with hypertension complicated with type 2 diabetes mellitus(T2 DM).Methods Clinical medical records of 200 patients with hypertension complicated with T2 DM who were admitted to the Third Hospital of Nanchang from January 2018 to December 2019 were retrospectively analyzed.According to whether there were macrovascular diseases,the patients were divided into macrovascular disease group(MA group)and non-macrovascular disease group(non-MA group).The clinical medical records were collected in both groups,the influencing factors of macrovascular disease in the patients with hypertension complicated with T2 DM were identified,and the multi-factor analysis was carried out.Results Single factor analysis showed that the course of T2 DM,smoking,systolic blood pressure(SBP),fasting blood glucose(FPG),2 h postprandial blood glucose(2 hPG),glycated hemoglobin(HbAlc),triglycerid(TG),low density lipoprotein cholesterol(LDL-C)might be factors in the development of macrovascular disease in the patients with hypertension complicated with T2 DM(P<0.05);through multi-factor Logistic regression analysis,the course of T2 DM,smoking,SBP,FPG,2 hPG,HbAlc,TG,LDL-C could increase the risk of macrovascular disease in the patients with hypertension comlicated with T2 DM by2.915(1.575-5.393)times,3.013(1.501-6.048)times,1.862(1.024-3.387)times,4.354(2.108-8.992)times,1.984(1.073-3.668)times,2.048(1.123-3.734)times,1.965(1.068-3.618)times,and 1.926(1.057-3.509)times.Conclusion The course of T2 DM,smoking,SBP,FPG,2 hPG,HbAlc,TG,LDL-C are independent risk factors for macrovascular disease in the patients with hypertension complicated with T2 DM.Therefore,actively controlling patients’blood pressure and blood sugar,improving diet,and strengthening smoking cessation management are of great significance in preventing macrovascular disease in the patients with hypertension complicated with T2 DM.