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不同健康相关指标对老年糖尿病合并冠心病患者预后预测价值分析

Prognostic value of different health-related indicators in elderly patients with diabetes mellitus and coronary heart disease
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摘要 目的分析不同健康相关指标对老年糖尿病合并冠心病患者预后的影响,为糖尿病合并冠心病患者的诊疗提供理论依据。方法选取2018年12月至2020年12月江苏省人民医院和海安市人民医院收治的老年糖尿病合并冠心病患者456例,根据患者出院后1年内是否发生主要心血管不良事件(major adverse cardiovascular events,MACE)分为对照组(未发生MACE)和观察组(发生MACE),从病历系统收集患者临床资料,包括患年龄、性别、BMI、吸烟、饮酒情况、糖尿病病程、冠状动脉狭窄程度、病变支数等,采用单因素分析和logistic回归分析收缩压、LEVF、HbA1c、LDL-C、LDH)及ALP等健康相关指标对糖尿病合并冠心病患者发生MACE的影响,并采用Spearman相关分析对不同健康相关指标与老年糖尿病合并冠心病患者发生MACE的相关性进行分析。结果456例老年糖尿病合并冠心病患者中发生MACE 122例(26.75%),年龄、男性比例、BMI、吸烟、饮酒糖尿病病程两两组间比较差异无统计学意义(P>0.05)。观察组冠状动脉狭窄程度和病变支数明显高于对照组(P<0.05),HbA1c、LEVF、LDL-C、TC、TG、BUA两两组间比较差异有统计学意义(P<0.05)。HbA1c>7.0%(OR=2.617)、LDL-C>2.6 mmol/L(OR=2.976)和BUA>420μmol/L(OR=2.341)是老年糖尿病合并冠心病患者发生MACE的独立危险因素(P<0.05)。Spearman相关分析显示HbA1c、LDL-C、BUA水平与老年糖尿病合并冠心病患者发生MACE均呈正相关(r=0.401,0.427,0.372,P<0.05)。结论老年糖尿病合并冠心病患者发生MACE的风险较高,与健康相关指标密切相关,对于HbA1c>7.0%、LDL-C>2.6 mmol/L和BUA>420μmol/L的患者,应积极进行治疗,有助于改善患者预后。 Objective To analyze the influence of different health-related indicators on the prognosis of elderly patients with diabetes mellitus complicated with coronary heart disease,and to provide theoretical basis for the diagnosis and treatment of diabetes mellitus complicated with coronary heart disease.Methods Among of 456 elderly patients with diabetes mellitus complicated with coronary heart disease admitted to Jiangsu Provincial People′s Hospital and Hai′an People′s Hospital from December 2018 to December 2020 were selected.According to the occurrence of Major adverse cardiovascular events(MACE)within 1 year after discharge,patients were divided into the control group(no MACE)and the observation group(MACE).The Clinical data of patients including age,gender,BMI,smoking,alcohol consumption,diabetes course,degree of coronary artery stenosis and number of lesions,were collected from the medical record system.Univariate analysis and logistic regression were used to analyze the influence of health indicators such as systolic blood pressure,LEVF,HbA1c,LDL-C,LDH and ALP on the occurrence of MACE in patients with diabetes and coronary heart disease.Spearman correlation analysis was used to analyze the correlation between different health-related indicators and the occurrence of MACE in elderly patients with diabetes mellitus and coronary heart disease.Results A total of 456 elderly patients with diabetes mellitus and coronary heart disease,122 cases(26.75%)developed MACE.There were no differences in age,male proportion,BMI,smoking and drinking of diabetes course between the two groups(P>0.05).The degree and number of coronary artery stenosis in the observation group were significantly higher than those in the control group(P<0.05).There were significant differences in HbA1c,LEVF,LDL-C,TC,TG and BUA between the two groups(P<0.05).HbA1c>7.0%(OR=2.617),LDL-C>2.6 mmol/L(OR=2.976)and BUA>420μmol/L(OR=2.341)were independent risk factors for MACE in elderly patients with diabetes mellitus and coronary heart disease(P<0.05).Spearman correlation analysis showed that HbA1c,LDL-C,BUA were positively correlated with MACE in elderly patients with diabetes mellitus and coronary heart disease(r=0.401,0.427,0.372,P<0.05).Conclusion Elderly patients with diabetes mellitus complicated with coronary heart disease have a higher risk of MACE,which is closely related to health-related indicators.For patients with HbA1c>7.0%,LDL-C>2.6 mmol/L and BUA>420μmol/L,active treatment should be conducted to improve the prognosis of patients.
作者 仇思洁 宋格 黄奔 QIU Sijie;SONG Ge;HUANG Ben(Department of Laboratory,Jiangsu Provincial People′s Hospital,Nanjing,Jiangsu 210029,China;Department of Laboratory,Hai′an People′s Hospital,Haian,Jiangsu 226600,China)
出处 《公共卫生与预防医学》 2023年第5期103-106,共4页 Journal of Public Health and Preventive Medicine
关键词 糖尿病合并冠心病 心血管不良事件 预后 Diabetes mellitus complicated with coronary heart disease Cardiovascular adverse events Prognosis
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