低血糖对青年2型糖尿病患者心血管事件的影响  

Effects of hypoglycemia on cardiovascular events in young patients with type 2 diabetes

作　　者：张杰[1] 方红辉[2] 王曼曼[3] 

机构地区：[1]暨南大学第二临床医院(深圳市人民医院)第二门诊部,广东省深圳市508020 [2]暨南大学第二临床医院(深圳市人民医院)检验科,广东省深圳市508020 [3]中山大学附属第三医院内分泌科

出　　处：《中国心血管病研究》2017年第4期321-324,共4页Chinese Journal of Cardiovascular Research

基　　金：2013年广东省自然科学基金项目（项目编号：S2013010011533）

摘　　要：目的 探讨低血糖对青年2型糖尿病患者心血管事件的影响.方法 采用回顾性研究方法,选择2014年8月到2016年6月在我院内分泌科诊治的青年2型糖尿病患者360例,收集所有患者的病历资料和血压样本检测结果,记录低血糖发生情况及调查相关因素,随访心血管事件发生情况.结果 360例患者根据2型糖尿病患者是否发生低血糖分为低血糖组（n=20）和对照组（n=340）,两组的HDL-C、HbA1c、LDL-C、TG、TC值等比较未见统计学差异（P＞0.05）,但低血糖组的SCr、CRP、CK等值都明显高于对照组（P＜0.05）.通过Logistic回归分析发现,引起低血糖的主要因素为年龄（OR=1.944）、病程（OR =3.784）、CRP（OR=2.874）和CK（OR =2.785）.所有患者随访6个月,低血糖组的不稳定型心绞痛、心力衰竭、靶血管血运重建、猝死等心血管事件发生率为40.0％,明显高于对照组的3.8％（P＜0.05）.结论 青年2型糖尿病患者存在低血糖状况,主要发病因素包括年龄、病程、CRP、CK等,可导致心血管事件的增加,在临床上要积极进行预防性控制.Objective To investigate the effects of hypoglycemia on cardiovascular events in young patients with type 2 diabetes.Methods From August 2014 to June 2016,360 young patients with type 2 diabetes in our hospital department of Endocrinology were selected.The sample data were collected and the blood pressure test results was recorded for all patients.The hypoglycemia and the the related factors were recorded and investigated.The occurrence of cardiovascular events were followed up.Results There were 20 patients of hypoglycemia in the 360 patients,the occur rate was 5.6%.Accorded to whether hypoglycemia the patients with type 2 diabetes were divided into hypoglycemia group （n=20） and control group （n=340）.There were no significant difference in HDL-C,HbAlc,LDL-C,TG and TC values between the two groups（P〉0.05）,but the SCr,CRP,CK value in the hypoglycemia group were significantly higher than the control group（P〈0.05）.Logistic stepwise regression analysis showed that age （OR =1.944）,course of disease（OR=3.784）,CRP（OR=2.874）,CK（OR=2.785） were the independent risk factors for the occurrence of hypoglycemia （P〈0.05）.All patients were followed up for 6 months,the incidence of unstable angina,heart failure,target vessel revascularization,sudden death and other cardiovascular events in the hypoglycemia group was 45%,so that was 3.8% in the control group （P〈0.05）.Conclusion The prevalence of hypoglycemia is common in young patients with type 2 diabetes,the age,course of disease,CRP,CK are the independent risk factors for the occurrence of hypoglycemia that can lead to the increase of cardiovascular events,in the clinical should actively carry out preventive control.

关 键 词：青年人 2型糖尿病 低血糖 心血管事件 危险因素 

分 类 号：R587.1[医药卫生—内分泌]