比较新发老年2型糖尿病患者与中年患者心脑血管疾病影响因素  

Influence factors of cardiovascular and cerebrovascular diseases in elderly and middle-aged patients with new-onset type 2 diabetes mellitus

作　　者：林珊珊[1] 佘其美[1] 杨雪梅[1] 王隽书[1] 田应芳[1] 杨静[1] LIN Shan-shan;SHE Qi-mei;YANG Xue-mei;WANG Jun-shu;TIAN Ying-fang;YANG Jing

机构地区：[1]首都医科大学石景山教学医院北京市石景山医院内分泌科,北京100043

出　　处：《中国循证心血管医学杂志》2017年第4期446-448,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的比较新发老年2型糖尿病患者与中年患者的心脑血管疾病影响因素。方法回顾性分析2012年1月~2016年1月于北京市石景山医院住院的新发病的2型糖尿病患者470例的病例资料,其中男性283例,女性187例,年龄范围40~76岁。依据诊断时的年龄分为老年组(310例,≥60岁)和中年组(160例,40岁<年龄<60岁)。比较两组患者的血脂、血压、臀围、腰围、体质指数、高敏C反应蛋白(hs-CRP)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、肌酐(Cr)、尿酸(UA)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、胰岛素抵抗指数、胰岛B细胞功能以及肾小球滤过率(eGFR)。结果与中年组比较,老年组肾小球滤过率降低[(129.77±12.29)ml/mim·1.73 m2 vs.(111.18±17.26)ml/mim·1.73 m2],收缩压增高[(125.54±8.77)mm Hg vs.(133.5±7.53)mm Hg],差异有统计学意义(P均<0.05)。老年组与中年组在血脂、臀围、腰围、体质指数、hs-CRP、ALT、AST、UA、Cr、HbA1c、FBG、胰岛素抵抗指数以及胰岛B细胞功能等方面比较,差异均无统计学意义(P均>0.05)。结论新发老年2型糖尿病患者较中年患者肾小球滤过率下降,收缩压升高,在降血糖、降血脂等综合治疗的同时,加强对血压、肾小球滤过率的控制。Objective To compare the influence factors of cardiovascular and cerebrovascular diseases in elderly and middle-aged patients with new-onset type2diabetes mellitus(T2DM).Methods The patients(n=470,male283,female187and aged from40to76)were chosen from the Beijing Shijingshan Hospital from Jan.2012to Jan.2016.All patients were divided,according to their ages,into elderly group(n=310,age≥60)and middle-aged group(n=160,40<age<60).The indexes of blood fat,blood pressure(BP),hipline,waistline,body mass index(BMI),high-sensitivity C-reactive protein(hs-CRP),alamine aminotransferase(ALT),aspartate aminotransferase(AST),serum creatinine(SCr),uric acid(UA),glycated hemoglobin(HbAlc),fasting blood glucose(FBG),insulin resistance index(IRI),islet-B-cell function and glomerular filtration rate(GFR)were compared between2groups.Results The level of GFR decreased[(129.77±12.29)mL/mim·1.73m2vs.(111.18±17.26)mL/mim·1.73m2]and systolic blood pressure(SBP)increased[(125.54±8.77)mmHg vs.(133.5±7.53)mmHg]in elderly group compared with middle-aged group(all P<0.05).The difference in indexes of blood fat,hipline,waistline,BMI,hs-CRP,ALT,AST,UA,Cr,HbA1c,FBG,IRI and islet-B-cell function had no statistical significance between2groups(allP>0.05).Conclusion The level of GFR decreases and SBP increases in elderly patients compared with middleaged patients.The controls of BP and GFR should be strengthened during the comprehensive treatment for downregulation of blood sugar and blood fat.

关 键 词：老年新发2型糖尿病 高血压 肾小球滤过率 

分 类 号：R587.1[医药卫生—内分泌]