中青年糖尿病合并高血压病的危险因素分析及随访研究  

The risk factors analysis and follow-up study of middle-aged and young hypertensive diabetic patients

作　　者：王志军[1] 周建芝[1] 田立超[1] 李世超[1] 张志强[1] 张放[1] 陈旭[1] 曹佳佳[1] 吴寿岭[2] 

机构地区：[1]河北联合大学附属医院心内科,河北唐山063000 [2]河北联合大学附属开滦医院心内科

出　　处：《临床心血管病杂志》2014年第8期688-691,共4页Journal of Clinical Cardiology

摘　　要：目的：分析中青年糖尿病合并高血压病的患病率及危险因素,评价心肌梗死、脑卒中（包括脑梗死及脑出血）、肾脏功能不全等靶器官损害。方法：选取5 831例中青年2型糖尿病患者,分析高血压病的患病率、危险因素及靶器官损害。随访5年,记录心肌梗死、脑卒中及死亡等事件的发生,分析糖尿病患者高血压病的累计发病率及危险因素。结果：5 831例中青年糖尿病患者中,3 428例患高血压病,患病率为58.8%。单因素分析结果显示：女性和男性糖尿病患者高血压患病率分别为55.0%和63.5%,小于40岁和40～60岁患者高血压患病率分别为43.3%和59.9%,不吸烟和吸烟患者高血压患病率分别为57.1%和59.8%,正常体重和肥胖患者高血压患病率分别为53.5%和72.1%,三酰甘油（TG）正常组和高TG组患者高血压患病率分别为54.6%和62.8%,胆固醇（CHO）正常组和高CHO组患者高血压患病率分别为57.1%和62.0%,低密度脂蛋白（LDL-C）正常组和高LDL-C血症组患者高血压患病率分别为57.6%和65.3%,血尿酸正常组和高尿酸血症组患者高血压患病率分别为58.1%和70.6%,各组差异有统计学意义（均P〈0.01）。多因素Logistic回归分析结果显示：性别为男性、年龄增加、吸烟、肥胖、TG、TC、LDL-C水平升高均与中青年糖尿病合并高血压病相关。中青年糖尿病正常血压组及高血压组患者脑梗死患病率分别为1.2%和3.1%、脑出血患病率为0.1%和0.5%、肾功能不全患病率为9.6%和19.4%,各组差异均有统计学意义（均P〈0.01）。随访5年,中青年糖尿病正常血压组患者高血压累计发病率为31.7%;正常血压组和高血压病组患者心肌梗死发生率分别为0.5%和2.6%,脑梗死发生率分别为1.5%和2.8%,脑出血发生率分别为0.2%和0.6%,死亡发生率分别为1.3%和2.0%,各组差异有统计学意义（均P〈0.01）。结论：男性、年龄增加、吸烟、肥胖、TG、TC、LDL-C水平升�Objective：To analyze the prevalence, risk factors and target organ damage including myocardial in- farction, cerebral infarction, cerebral hemorrhage and renal insufficiency in middle-aged and young hypertensive diabetic patients. Method：A total of 5 831 middle-aged and young diabetic patients were selectedand analyzed the prevalence, risk factors and target organs damage. They were followed up for 5 years and the cumulative hyper- tensive incidence, eardiocerebrovascular events （including myocardial infarction, stroke, and death） and risk fac- tors were assessed. Resul：Of all, 3 428 cases had hypertension and the hypertensive prevalence was 58.8o/00. Re- sults of single factor analysis revealed that the hypertensive prevalence in female and male patients was 55.0 % vs 63.5%, in less than 40 years and 40～60 years old patients was 43.30% vs 59.9%, in non-smoking and smoking patients was 57.1% vs 59.8%, in normal weight and obese patients was respectively 53.5% and 72.1%, in nor- mal triglyceride （TG） and high TG group was 54.6% vs 62.8%, in normal cholesterol （CHO） and high level CHO group was 57.1% vs 62.0%, in normal low density lipoprotein （LDL-C） and high level LDL-C group was 57.6% vs 65.3%, in normal uric acid and hyperuricemia group was 58.1% vs 70.6%. Their differences were sig-nificant （all P〈0.01）. Results of multiariable logistic regression analysis showed male gender, aging, smoking, obesity, high levels TG, TC, LDL-C were risk factors for middle-aged and young hypertensive diabetic patients. The prevalence of cerebral infarction, cerebral hemorrhage, renal insufficiency in normotensive and hypertensive group was 1.2% vs 3.1%, 0.1% vs 0.5% ,and 9.6% vs 19.4%, respectively. Their differences were significant （all P%0.01）. After 5-year follow-up, 1351 case in 3370 middle-aged and young normotensive diabetic patients had hypertension and the 5 years accumulative hypertensive incidence was 31.7 %. The incidence rates of MI,cere- bral infarction, cerebral hemorrhage and dea

关 键 词：高血压 糖尿病 危险因素 心脑血管事件 

分 类 号：R544.1[医药卫生—心血管疾病]