慢性肾功能不全对糖尿病合并冠心病患者临床表现及预后的影响

发布时间：2018-07-05 03:27

本文选题：糖尿病 + 肾功能不全　；参考：《中国老年学杂志》2017年15期

【摘要】：目的探讨慢性肾功能不全对糖尿病合并冠心病患者临床表现及预后的影响。方法对120例确诊为冠心病的糖尿病患者进行研究,在患者入院后将他们分为两组,观察组为合并有慢性肾功能不全的患者75例,对照组则为单纯的确诊为冠心病的糖尿病患者45例,对两组患者的冠状动脉病变情况和临床特点进行比较,通过1年的随访了解两组患者的心血管事件的发生情况。结果高血压患病率观察组高于对照组(80.0%vs 57.8%,P0.05);左室射血分数观察组显著低于对照组(P0.05);室间隔厚度观察组显著高于对照组(P0.05);三支病变率观察组显著高于对照组(69.3%vs 33.3%,P0.05);多处钙化高于对照组(58.7%vs 28.9%,P0.05);接受药物治疗的概率观察组显著高于对照组(70.7%vs 33.3%,P0.05)。随访发现观察组发生急性左心衰竭(28.0%)和不稳定心绞痛(48.0%)的概率显著高于对照组(11.1%,26.7%,P0.05),其中有4例患者心肌梗死。结论冠心病合并肾功能不全的糖尿病患者,有明显的冠状动脉钙化,症状不突出,发生急性心力衰竭的患者人数多。慢性肾功能不全在预测糖尿病合并冠心病患者的心血管不良事件的发生具有重要作用。
[Abstract]:Objective to investigate the effect of chronic renal insufficiency on the clinical manifestation and prognosis of diabetic patients with coronary heart disease. Methods 120 patients with diabetes mellitus diagnosed as coronary heart disease were divided into two groups after admission. The observation group was 75 patients with chronic renal insufficiency. In the control group, 45 cases of diabetes mellitus were diagnosed as coronary heart disease. The coronary artery disease and clinical characteristics of the two groups were compared, and the occurrence of cardiovascular events in the two groups was studied through a 1-year follow-up. Results the prevalence of hypertension in the observation group was higher than that in the control group (80.0%vs 57.8), the left ventricular ejection fraction in the observation group was significantly lower than that in the control group (P0.05), the ventricular septal thickness observation group was significantly higher than that in the control group (P0.05); Calcification was higher than the control group (58.7%vs 28.9g), and the probability of receiving drug therapy in the observation group was significantly higher than that in the control group (70.7%vs 33.3g P 0.05). The probability of acute left heart failure (28.0%) and unstable angina pectoris (48.0%) in the observation group was significantly higher than that in the control group (11.1% 26.7p0.05). Conclusion patients with coronary heart disease complicated with renal insufficiency have obvious coronary artery calcification, symptoms are not prominent, and the number of patients with acute heart failure is high. Chronic renal insufficiency plays an important role in predicting cardiovascular adverse events in diabetic patients with coronary heart disease.
【作者单位】：东莞市人民医院心内科;
【分类号】：R541.4;R587.1

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