冠心病合并糖尿病患者dTP分析及随访

发布时间：2018-06-25 02:15

本文选题：冠心病 + 糖尿病　；参考：《重庆医学》2017年22期

【摘要】：目的分析冠心病(CHD)合并糖尿病(DM)患者11脱氢血栓素B2/6-酮前列环素比值(11-dh-TXB2/6-k-PGF1a,dTP)及与主要不良心血管事件(MACE)和再住院之间的关系。方法选择2013年7月至2014年6月270例CHD患者作为研究对象,其中136例非DM患者(非DM组),134例合并DM患者(DM组)。记录患者临床情况,测量身高、体质量、血压、心率等指标,完善心电图、超声心动图、冠状动脉造影等检查。测定两组患者11-dh-TXB2和6-k-PGF1a水平,计算dTP值。随访1年,记录患者MACE事件及再次住院情况。Epdate软件建库,SPSS 17.0软件进行统计分析。结果非DM组与DM组dTP分别为1.8±0.6和2.0±0.7,差异有统计学意义(P0.05)。对于非DM组,hs-CRP、收缩压、舒张压、冠状动脉病变数及严重病变数与dTP相关(P0.05)。而对于DM组,hs-CRP、血糖、胆固醇水平、冠状动脉病变数及严重病变数与dTP相关(P0.05)。随访1年,非DM组和DM组患者发生MACE事件分别为33例(24.3%)和44例(32.8%),两组比较差异无统计学意义(P0.05)。非DM组和DM组再次住院患者分别为12例(8.8%)和24例(17.9%),两组比较差异有统计学意义(P0.05)。发生MACE的患者与无MACE的患者住院时dTP分别为2.3±0.8和1.8±0.6,差异有统计学意义(P0.05)。再住院患者与未再住院组患者住院时dTP分别为2.4±1.0和1.9±0.6,差异有统计学意义(P0.05)。结论 CHD合并DM患者dTP明显增高,提示血小板明显活化,且较高的dTP增加了患者MACE事件及再次住院风险,应该强化抗血小板治疗。
[Abstract]:Objective to analyze the relationship between 11 dehydrothromboxane B 2 / 6 keto-prostacyclin ratio (11-dh-TXB 2 / 6-k-PGF1aTTP) and major adverse cardiovascular events (Mace) and rehospitalization in patients with coronary heart disease (CHD) and diabetes mellitus (DM). Methods from July 2013 to June 2014, 270 patients with CHD were selected as study subjects, including 136 non-DM patients (non-DM group) and 134 patients with diabetes mellitus (DM group). Record the clinical condition, measure the height, body mass, blood pressure, heart rate, perfect electrocardiogram, echocardiography, coronary angiography and so on. The levels of 11-dh-TXB2 and 6-k-PGF1a were measured and the dTP values were calculated. All patients were followed up for 1 year to record Mace events and re-hospitalization. SPSS 17.0 software was used to analyze the data set up by Epdate software. Results the dTP of non-DM group and DM group were 1.8 卤0.6 and 2.0 卤0.7, respectively. The difference was statistically significant (P0.05). In non-DM group, systolic blood pressure, diastolic blood pressure, number of coronary artery lesions and the number of severe lesions were correlated with dTP (P0.05). In DM group, the levels of hs-CRP, blood glucose, cholesterol, the number of coronary artery lesions and the number of severe lesions were correlated with dTP (P0.05). After 1 year follow-up, 33 cases (24.3%) and 44 cases (32.8%) had Mace events in non-DM group and DM group, respectively. There was no significant difference between the two groups (P0.05). There were 12 cases (8.8%) and 24 cases (17.9%) in non-DM group and DM group, respectively. The difference between the two groups was statistically significant (P0.05). The DTP of patients with Mace and those without Mace were 2.3 卤0.8 and 1.8 卤0.6, respectively. The difference was statistically significant (P0.05). DTP was 2.4 卤1.0 and 1.9 卤0.6 in the re-hospitalized group and the non-re-hospitalized group, respectively. The difference was statistically significant (P0.05). Conclusion the increase of dTP in CHD patients with DM suggests that platelet activation and high DTP increase the risk of Mace events and re-hospitalization in patients with CHD and diabetes mellitus, so antiplatelet therapy should be strengthened.
【作者单位】：华北理工大学附属医院心血管内科;华北理工大学校医院;
【基金】：河北省卫生厅医学研究重点课题计划项目(20100474)
【分类号】：R541.4;R587.1

【相似文献】