冠心病合并2型糖尿病心血管事件发生风险的Meta分析

The Risk of Cardiovascular Events in Patients with Coronary Heart Disease Combined with Type 2 Diabetes: Meta-Analysis

目的:综合评价2型糖尿病与冠心病患者心血管事件发生风险的关系。方法:运用计算机检索中国生物医学文献数据库(CBM)、中国学术期刊全文数据库(CNKI)、维普、万方和PubMed数据库,收集1980年以来至2020年8月国内外公开发表的有关2型糖尿病与冠心病患者心血管事件发生相关的研究文献,采用stata12.0软件进行统计学分析。结果:共纳入11篇文献,中文文献9篇,英文文献2篇。漏斗图显示所纳入文献中,经中英文分组分析后未发现显著发表偏倚,可靠性较强。本研究所用病例中糖尿病患者以空腹血糖 】6.11 mmol/L为标准,本次研究共计包括5490名研究对象。Meta分析结果显示,与对照组相比冠心病患者合并2型糖尿病组心肌梗塞、心律失常、心力衰竭等心血管事件发生风险明显高于单纯冠心病患者(P 【0.05)。结论:较早的讨论糖尿病对冠心病患者预后的影响的文献,发现2型糖尿病与冠心病患者心血管事件发生风险之间关系密切,说明2型糖尿病可能是冠心病患者发生心血管不良事件发生风险增加的原因之一。2型糖尿病导致的高血糖可能会与患病时间、血脂、血压、体重等因素共同作用增加冠心病患者心血管疾病发生的风险,但因所纳入文献可能还因文献质量和纳入病例数量限制,上述结论还需进一步研究进行验证。

Objective: To evaluate the relationship between type 2 diabetes and the risk of cardiovascular events in patients with coronary heart disease. Method: Using computer to retrieve the Chinese biomedical literature database (CBM), China academic journal full-text database (CNKI), VIP, Wanfang data and PubMed database, collected from 1980 to February 2020, published at home and abroad related to type 2 diabetes and cardiovascular events in patients with coronary heart disease in relevant research literature;using stata12.0 software for statistical analysis. Results: A total of 11 articles, 9 articles in Chinese and 2 articles in English were included. Funnel plots showed that no significant publication bias was found in the included literature after grouping analysis in both Chinese and English. The fasting blood glucose of diabetic patients in this study was >6.11 mmol/L as the standard. This study included 5490 subjects. The results of meta-analysis all showed that the risk of cardiovascular events in patients with coronary heart disease with type 2 diabetes was significantly higher than that in patients with simple coronary heart disease. Conclusion: There is a close relationship between type 2 diabetes and the risk of cardiovascular events in patients with coronary heart disease, suggesting that type 2 diabetes may be one of the reasons for the increased risk of cardiovascular adverse events in patients with coronary heart disease. Hyperglycemia caused by type 2 diabetes may increase the risk of cardiovascular disease in patients with CHD together with the duration of the disease, blood lipid, blood pressure, weight and other factors. However, due to the limitation of literature quality and the number of included cases, the above conclusion still needs to be verified by further studies.