血管紧张素转换酶对糖尿病合并高血压患者心脑血管事件的预测价值

发布时间：2018-04-02 00:33

本文选题：糖尿病　切入点：糖尿病并发症　出处：《中华老年心脑血管病杂志》2016年11期

【摘要】：目的探讨血管紧张素转换酶(ACE)对糖尿病合并高血压患者心脑血管事件的预测价值。方法选择糖尿病合并高血压患者312例,根据ACE水平分为ACE较高组157例和ACE较低组155例,测定基线ACE水平、收集基线资料后平均随访73.3个月,比较2组心脑血管事件发生情况。结果 ACE较高组脑梗死(14.66/千人年vs5.30/千人年)和总心脑血管事件(24.08/千人年vs 9.53/千人年)发生率明显高于ACE较低组,差异有统计学意义(P0.05)。2组心肌梗死(4.19/千人年vs 2.12/千人年)、心源性猝死(2.09/千人年vs 1.06/千人年)和脑出血(3.14/千人年vs 1.06/千人年)发生率比较,差异无统计学意义(P0.05)。采用Cox比例风险回归模型分析显示,校正协变量后,ACE水平较高仍是总心脑血管事件的危险因素(RR=1.27,95%CI:1.04~3.18,P=0.042)。结论糖尿病合并高血压患者中ACE水平升高是心脑血管事件发生的危险因素。
[Abstract]:Objective to investigate the value of angiotensin converting enzyme (ACE) in predicting cardiovascular and cerebrovascular events in diabetic patients with hypertension. Methods 312 diabetic patients with hypertension were divided into higher ACE group (157 cases) and lower ACE group (155 cases). The baseline ACE level was measured and the baseline data were collected and followed up for an average of 73.3 months. Results the incidence of cerebral infarction and total cardiovascular events in the ACE group was significantly higher than that in the lower ACE group (14.66 / 1000 vs5.30/ per year) and 24.08 / 1000 person year vs 9.53 / 1000 person year respectively, and the incidence of cardiovascular and cerebrovascular events in the two groups was significantly higher than that in the lower ACE group. There were significant differences in the incidence of myocardial infarction (4.19 / 1000 person years vs 2.12 / 1000 person years, sudden cardiac death 2.09 / 1000 years vs 1.06 / 1000 person years) and intracerebral hemorrhage (3.14 / 1000 person years vs 1.06 / 1000 person years). The difference was not statistically significant (P 0.05). The Cox proportional risk regression analysis showed that, The higher level of ACE is still the risk factor of total cardiovascular and cerebrovascular events. Conclusion the increase of ACE level in diabetic patients with hypertension is a risk factor of cardiovascular and cerebrovascular events.
【作者单位】：华北理工大学附属医院神经外科;华北理工大学公共卫生学院;
【基金】：河北省医学科学研究重点课题计划(ZD20140173)
【分类号】：R544.1;R587.1

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