空腹血糖水平与高血压患者血栓栓塞事件的相关性研究

The correlation between fasting blood glucose levels and thromboembolic events in hypertensive patients

目的分析空腹血糖水平与高血压患者血栓栓塞事件的相关性。方法纳入我院在2019年1月至2022年1月期间的高血压患者共987例进行研究,所有患者均随访至2023年7月,依据患者血栓栓塞事件发生情况分为两组,其中260例患者发生血栓栓塞事件设为栓塞组,其余727例患者未发生血栓栓塞事件设为对照组。对两组患者的各项资料进行单因素分析,对有统计学意义的因素行Logistic多因素分析,分析高血压患者血栓栓塞事件发生的危险因素。依据患者入组时空腹血糖水平分为血糖正常组(n=627)、糖尿病前期组(n=107)、血糖控制严格糖尿病组(n=60)、血糖控制一般糖尿病组(n=43)、血糖控制不佳糖尿病组(n=150),比较不同空腹血糖水平患者血液高凝状态指标水平及血栓栓塞事件发生情况,并分析空腹血糖水平和高血压患者血栓栓塞事件的相关性。结果栓塞组患者的年龄、男性占比、体质量指数、非瓣膜病性心房颤动、脑卒中危险评分(CHA_(2)DS_(2)-VASc)、心房颤动抗凝治疗出血风险评分(HAS-BLED)、血管疾病占比、心力衰竭占比、血栓栓塞占比、糖尿病占比、空腹血糖水平、血小板计数水平均高于对照组(P<0.05)。Logistic回归模型结果显示,体质量指数≥26 kg/m^(2)、空腹血糖≥6.1 mmol/L均为高血压患者血栓栓塞事件发生的危险因素(P<0.05)。血糖正常组患者的PT水平高于其他各组,APTT、FIB、D-二聚体水平低于其他各组,其中糖尿病前期组、血糖控制严格糖尿病组、血糖控制一般糖尿病组、血糖控制不佳糖尿病组患者的PT水平依次降低,APTT、FIB、D-二聚体水平依次升高(P<0.05)。血糖控制不佳糖尿病组患者的急性心肌梗死、急性脑梗死、急性肺栓塞发生率明显高于其他各组(P<0.05);各组间短暂性脑缺血发作、下肢静脉血栓发生率比较差异无统计学意义(P>0.05)。Pearson相关性分析,空腹血糖水平与高血压患者血栓栓塞事件呈现正相关(r=0.912,P=0.007)。结论体质量指数、空腹血糖水平均为高血压患者血栓栓塞事件发生的危险因素,且空腹血糖水平与高血压患者血栓栓塞事件呈现正相关。

Objective To analyze the correlation between fasting blood glucose levels and thromboembolic events in hypertensive patients.Methods A total of 987 hypertensive patients enrolled in our hospital from January 2019 to January 2022 were studied.All patients were followed up until July 2023 and divided into two groups based on the occurrence of thromboembolic events.Among them,260 patients with thromboembolic events were designated as the embolization group,while the remaining 727 patients without thromboembolic events were designated as the control group.Single factor analysis was conducted and logistic multivariate analysis was performed on statistically significant factors to analyze the risk factors for thromboembolism events in hypertensive patients.The patients were divided into normal blood glucose group(n=627),pre-diabetes group(n=107),strict control diabetes group(n=60),general control diabetes group(n=43),and poor control diabetes group(n=150)according to their fasting blood glucose levels.And analyze the correlation between fasting blood glucose levels and thromboembolic events in hypertensive patients.Results The age,male proportion,body mass index,non-valvular atrial fibrillation,stroke risk score(CHA_(2)DS_(2)-VASc),atrial fibrillation anticoagulation therapy bleeding risk score(HAS-BLED),vascular disease proportion,heart failure proportion,thromboembolism proportion,diabetes proportion,fasting blood glucose level,platelet count level of patients in the embolism group were higher than those in the control group(P<0.05).The results of the logistic regression model showed that body mass index≥26 kg/m^(2)and fasting blood glucose≥6.1 mM were all risk factors for thromboembolism events in hypertensive patients(P<0.05).The PT level of patients with normal blood glucose was higher than that of other groups,and the levels of APTT,FIB,D-dimer were lower than those of other groups.The PT level of patients with diabetes in the pre-diabetes group,strict control diabetes group,general control diabetes group,and poor control diabetes group reduced in turn,and the levels of APTT,FIB,D-dimer increased in turn(P<0.05).The incidence of acute myocardial infarction,acute cerebral infarction and acute pulmonary embolism in patients with poorly controlled diabetes group was significantly higher than that in other groups(P<0.05);There was no significant difference in the incidence of transient ischemic attacks and lower limb venous thrombosis among the groups(P>0.05).Pearson correlation analysis showed a positive correlation between fasting blood glucose levels and thromboembolic events in hypertensive patients(r=0.912,P=0.007).Conclusion Body mass index and fasting blood glucose levels are both risk factors for thromboembolic events in hypertensive patients,and fasting blood glucose levels are positively correlated with thromboembolic events in hypertensive patients.