老年2型糖尿病患者发生动脉粥样硬化性心血管疾病的危险因素分析

Analysis of Risk Factors for Atherosclerotic Cardiovascular Disease in Elderly Patients with Type 2 Diabetes Mellitus

目的探讨老年2型糖尿病患者(T2DM)合并动脉粥样硬化性心血管疾病(ASCVD)的现状,并分析其危险因素。方法采用方便抽样法,选取2022年7月-11月在延安大学附属医院内分泌代谢科住院的老年2型糖尿病患者作为调查对象,收集患者一般资料及疾病相关资料。按照患者是否合并ASCVD将其分为ASCVD组和无ASCVD组,进行单因素分析;并以患者是否发生ASCVD为因变量,将单因素分析中有统计学意义的变量纳入二元Logistic回归分析其独立危险因素。结果本研究共纳入219例老年2型糖尿病患者,发生ASCVD的患者有77例,发生率为35.16%,主要是冠心病与缺血性脑卒中。单因素分析显示,男性、吸烟或病程长的患者更易发生ASCVD,且女性发生ASCVD是男性的0.459倍,而动脉血管硬化等级(3~4级、5~6级)、合并周围血管病变、胆固醇(TC)3个变量进入二元Logistic回归方程(OR=2.430、11.194、3.059、0.459,P<0.05),且其是老年2型糖尿病患者发生ASCVD的独立危险因素。结论老年2型糖尿病患者ASCVD发生率较高,特别是男性、吸烟、病程长的患者,应定期检查、评估患者动脉血管硬化等级[踝肱动脉指数(ABI)、肱踝动脉脉搏波传导速度(baPWV)]、胆固醇等指标,并在生活方式及药物治疗依存性上给予相应健康指导,以延缓动脉硬化,降低患者ASCVD的发生率。

Objective To investigate the prevalence and risk factors of atherosclerotic cardiovascular disease(ASCVD)in elderly patients with type 2 diabetes mellitus(T2DM).Methods A convenient sampling method was used to select elderly patients with type 2 diabetes mellitus who were hospitalized in the Department of Endocrinology and Metabolism of the Affiliated Hospital of Yan'an University from July to November 2022 as the subjects of investigation.The general data and disease-related data of the patients were collected.According to whether the patients were combined with ASCVD,they were divided into ASCVD group and non-ASCVD group for univariate analysis.Taking the occurrence of ASCVD in patients as the dependent variable,the statistically significant variables in the univariate analysis were included in the binary Logistic regression analysis to analyze the independent risk factors.Results A total of 219 elderly patients with type 2 diabetes mellituswere included in this study.There were 77 patients with ASCVD,with an incidence of 35.16%,mainly coronary heart disease and ischemic stroke.Univariate analysis showed that patients were male,and with smoking or long course of disease were more likely to develop ASCVD,and the incidence of ASCVD in women was 0.459 times higher than that in men.The three variables of arterial sclerosis grade(grade 3-4,grade 5-6),peripheral vascular disease and cholesterol(TC)entered the binary logistic regression equation(OR=2.430,11.194,3.059,0.459,P<0.05),which were independent risk factors for ASCVD in elderly patients with type 2 diabetes mellitus.Conclusion The incidence of ASCVD in elderly patients with type 2 diabetes mellitusis high,especially in patients were male,and with male,smoking and long course of disease.Regular examination and evaluation of patients with arterial vascular sclerosis grade[ankle brachial artery index(ABI),brachial ankle pulse wave velocity(baPWV)],cholesterol and other indicators,and in the lifestyle and drug treatment dependence to give the corresponding health guidance,in order to delay atherosclerosis,reduce the incidence of ASCVD in patients.