2型糖尿病合并冠心病的流行状况和相关因素研究

发布时间：2019-03-12 14:41

【摘要】：目的:分析首次住院2型糖尿病(T2DM)合并冠心病患者的患病情况和分布特点,探讨多种因素与T2DM合并冠心病的关系,为T2DM患者合并冠心病的筛查和预防控制工作提供科学依据。方法:回顾性分析2012年5月15日至2013年5月20日在天津医科大学总医院和代谢病医院住院的T2DM患者的病历资料,摘录相关信息,内容包括:人口统计学特征、疾病史、疾病家族史、行为方式、体格检查及实验室检查资料,采用Epi Data软件建立数据库。以其中首次住院的T2DM患者作为研究对象,分析T2DM患者合并冠心病的患病率及其分布特点;采用病例对照方法,以T2DM合并冠心病者为病例组,未合并冠心病的T2DM患者为对照组,采用Logistic回归分析方法对T2DM合并冠心病的相关因素进行探讨。结果:本研究的872例T2DM患者中有冠心病患者460例,T2DM患者中冠心病患病率为52.8%;冠心病的患病率女性高于男性,且随着年龄的增长而增加。以T2DM合并冠心病患者460例作为病例组,未合并冠心病的T2DM患者412例作为对照组,单因素非条件Logistic回归分析结果显示:年龄大、女性、在婚、病程长、收缩压及舒张压高、糖尿病并发视网膜病变、糖尿病肾病、周围神经病变、高血压、脑血管病变、颈动脉硬化、下肢动脉硬化以及高血压家族史、冠心病家族史、尿素氮及肌酐与T2DM合并冠心病的高风险有统计学关联,而现吸烟、现饮酒、空腹血糖、红细胞增多及直接胆红素与T2DM合并冠心病的低风险有统计学关联;经调整可能的混杂因素后,女性、在婚、现饮酒、现吸烟、空腹血糖、糖尿病并发视网膜病变、糖尿病肾病、周围神经病变、高血压、脑血管病变、下肢动脉硬化及红细胞增多、直接胆红素与T2DM合并冠心病的统计学关联消失。未发现糖尿病家族史、体质指数、糖化血红蛋白水平、糖尿病足、脂代谢紊乱、高粘血症、高纤维蛋白原血症、总胆固醇、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇及24h尿微量白蛋白、血小板、C反应蛋白与T2DM合并冠心病存在统计学关联;但经年龄、性别和糖尿病病程调整后,体质指数与T2DM合并冠心病的高风险有关。结论:T2DM患者合并冠心病的患病率为52.8%,女性患病率高于男性,患病率随着年龄的增加而增加;糖尿病病程越长,T2DM患者合并冠心病的比例增加。年龄大、病程长、体质指数高、收缩压及舒张压高、高血压家族史、冠心病家族史、糖尿病合并颈动脉硬化、尿素氮及肌酐与T2DM合并冠心病的高风险有关;空腹血糖与与T2DM合并冠心病的低风险有关。
[Abstract]:Objective: to analyze the prevalence and distribution characteristics of type 2 diabetes mellitus (T2DM) complicated with coronary heart disease (CHD) in the first hospitalization, and to explore the relationship between multiple factors and T2DM complicated with coronary heart disease (CHD). To provide scientific basis for screening, prevention and control of coronary heart disease in patients with T2DM. Methods: the medical records of T2DM patients hospitalized in Tianjin Medical University General Hospital and Metabolic Disease Hospital from May 15, 2012 to May 20, 2013 were analyzed retrospectively. Family history, behavior pattern, physical examination and laboratory examination data were established by Epi Data software. The prevalence and distribution characteristics of coronary heart disease (CHD) in patients with T2DM were analyzed with T2DM patients who were hospitalized for the first time. A case-control method was used to study the related factors of T2DM complicated with coronary heart disease (CHD) by Logistic regression analysis, taking the patients with T2DM with coronary heart disease (CHD) as the case group and the T2DM patients without CHD as the control group. Results: there were 460patients with coronary heart disease (CHD) among 872 patients with T2DM in this study, and the prevalence rate of CHD in T2DM patients was 52.8%, and the prevalence of CHD in females was higher than that in males and increased with the increase of age. The results of univariate non-conditional Logistic regression analysis showed that age, duration of marriage, long course of disease, high systolic and diastolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly higher than those of T2DM patients without coronary heart disease (CHD). The results of univariate non-conditional Logistic regression analysis showed that: 1. Diabetic retinopathy, Diabetic Nephropathy, Peripheral Neuropathy, Hypertension, Cerebral Vascular Disease, carotid Arteriosclerosis, Lower limb Arteriosclerosis and Family History of Hypertension, Coronary Heart Disease, Urea nitrogen and creatinine were significantly associated with the high risk of T2DM complicated with coronary heart disease, while smoking, drinking, fasting blood glucose, erythrocythemia and direct bilirubin were significantly associated with the low risk of T2DM complicated with coronary heart disease. Adjusted for possible confounding factors, women, married, drinking, smoking, fasting blood glucose, diabetic retinopathy, diabetic nephropathy, peripheral neuropathy, hypertension, cerebral angiopathy, Lower extremity arteriosclerosis and erythrocythemia, direct bilirubin and T2DM complicated with coronary heart disease statistical association disappeared. No family history of diabetes, body mass index, glycosylated hemoglobin level, diabetic foot, lipid metabolism disorder, hyperviscosity, hyperfibrinogenemia, total cholesterol, high density lipoprotein cholesterol, Low density lipoprotein cholesterol (LDL-C), 24-hour urinary microalbuminuria, platelet and C-reactive protein were associated with T2DM complicated with coronary heart disease (CHD). However, after adjusted for age, sex and diabetes duration, BMI was associated with a high risk of T2DM complicated with coronary heart disease. Conclusion: the prevalence of coronary heart disease in patients with T2DM is 52.8%, which is higher in women than in men and increases with age, and the longer the course of diabetes, the more the proportion of patients with T2DM complicated with coronary heart disease. Age, long course of disease, high body mass index, high systolic and diastolic blood pressure, family history of hypertension, family history of coronary heart disease, diabetes mellitus complicated with carotid atherosclerosis, urea nitrogen and creatinine were associated with the high risk of T2DM complicated with coronary heart disease. Fasting blood glucose is associated with a low risk of T2DM associated with coronary heart disease.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1;R541.4

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