老年糖尿病患者基线临床特征对远期主要心血管不良事件的影响  

Effects of Baseline Clinical Characteristics on Major Adverse Cardiovascular Events in Elderly Diabetic Patients during Long-term Follow-up Period

作　　者：尹慧君 李晓利 范利[2] 张金花 徐成 孙沛 白秉学 张旭 Yin Huijun;Li Xiaoli;Fan Li(Department of Geriatric Ward,Eighth Medical Center of PLA General Hospital,Beijing 100091,China;不详)

机构地区：[1]中国人民解放军总医院第八医学中心干部病房,北京100091 [2]中国人民解放军总医院南楼临床部,北京100085 [3]中国人民解放军总医院第八医学中心ICU病房,北京100091

出　　处：《医学研究杂志》2020年第1期57-60,56,共5页Journal of Medical Research

基　　金：国家自然科学基金资助项目(81300252)。

摘　　要：目的分析老年糖尿病患者基线临床特征对远期主要心血管不良事件的影响作用。方法连续收集2008年4月~2010年7月北京地区部队干休所342例老年糖尿病患者(60~94岁),根据是否发生主要心血管不良事件分为两组,不良事件组36例,无不良事件组306例,随访4.4~6.7(5.7±0.9)年,主要心血管不良事件定义为随访期间发生急性非致死性心肌梗死、急性缺血性脑卒中、心源性死亡及血运重建。分析基线临床资料在不良事件组和无不良事件组中的差异性及COX回归法分析不良事件与基线临床资料的相关性。结果与无不良事件组比较,事件组临床特征表现为年龄偏高、运动减少、高胆固醇血症、冠心病、缺血性脑卒中比例升高等,差异有统计学意义(P<0.05)。COX多因素分析显示:年龄(HR=1.09,95%CI:1.03~1.15,P=0.00)、高胆固醇血症(HR=2.47,95%CI:1.25~4.87,P=0.01)和缺血性脑卒中病史(HR=1.99,95%CI:1.01~3.94,P=0.05)与主要心血管不良事件的发生呈正相关。结论年龄、高胆固醇血症与60岁之前有缺血性脑卒中病史是老年糖尿病患者远期发生主要心血管不良事件的危险因素。提示糖尿病患者中,及早干预高胆固醇血症对预防远期主要心血管不良事件的发生具有重要意义。Objective To analyze the influencing factors of major adverse cardiovascular events in elderly diabetic patients during Long-term follow-up period.Methods Totally 342 elderly patients with diabetes mellitus(60-94 years old)from April 2008 to July 2010 in the army cadres′sanatorium in Beijing were collected.The main adverse cardiovascular events were defined as acute non-fatal myocardial infarction,Non-fatal ischemic stroke,cardiac death and revascularization.During 4.4 to 6.7(5.7±0.9)years′follow-up period,36 patients with major adverse cardiovascular events and 216 without adverse events.The difference of baseline clinical data between adverse event group and without adverse event group was analyzed.Moreover,the correlation between adverse events and multiple factors was analyzed by COX regression.Results Compared with the non-adverse event patients,patients with adverse events were more likely to be older and have history of hypercholesterolemia and coronary heart disease and ischemic stroke and less like to exercise(P<0.05).COX multivariate analysis showed that aging(HR=1.09,95%CI:1.03-1.15,P=0.00),history of hypercholesterolemia(HR=2.47,95%CI:1.25-4.87,P=0.01)and history of ischemic stroke(HR=1.99,95%CI:1.01-3.94,P=0.05)were positively correlated with major adverse cardiovascular events.Conclusion Aging,hypercholesterolemia and basic history of ischemic cardiovascular disease before 60 years old are risk factors for major adverse cardiovascular events in elderly diabetic patients.It is suggested that early intervention of hypercholesterolemia in diabetic patients is of great significance in preventing major cardiovascular adverse events.

关 键 词：主要心血管不良事件 糖尿病 危险因素 

分 类 号：R967[医药卫生—药理学]