血糖控制不佳的2型糖尿病患者心血管病风险分析  

Risk Analysis of Cardiovascular Diseases in Patients with Poorly Controlled Diabetes Mellitus

作　　者：赵越 张梅 李伟 应长江 凌宏威 刘馨 张彤 程雪 ZHAO Yue;ZHANG Mei;LI Wei;YING Changjiang;LING Hongwei;LIU Xin;ZHANG Tong;CHENG Xue(Department of Endocrinology,The Affiliated Hospital of Xuzhou Medical University,Xuzhou 221000,Jiangsu,China)

机构地区：[1]徐州医科大学附属医院内分泌科,江苏徐州221000

出　　处：《心血管病学进展》2020年第5期551-555,共5页Advances in Cardiovascular Diseases

基　　金：国家自然科学基金(81701298);徐州市科技项目(KC17194)。

摘　　要：目的评估比较血糖控制良好和控制不佳的2型糖尿病患者未来10年心血管病风险及相关危险因素。方法收集本院内分泌科住院的2型糖尿病患者549例,根据其入院次日空腹糖化血红蛋白(HbA1c)测定结果,分为血糖控制不佳组(HbA1c>7%)408例和血糖控制良好组(HbA1c≤7.0%)141例,监测两组年龄、性别、现居地、吸烟史、饮酒史、个人疾病史、体重指数、腰围、收缩压、舒张压、血糖、总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白和纤维蛋白原等指标,并应用Framingham风险评估模型和China-PAR模型预测患者未来10年的心血管病发病风险。结果血糖控制不佳组收缩压、舒张压、空腹血糖、总胆固醇和低密度脂蛋白胆固醇平均值差异有统计学意义(P<0.05)。Framingham风险评估模型和China-PAR模型结果提示:血糖控制良好的2型糖尿病患者大多属于心血管病低、中风险,血糖控制不佳的2型糖尿病患者大多属于心血管病高风险。结论血糖控制不佳的糖尿病患者应更加注意心血管病危险因素的监测与控制,以降低其心血管病风险。Objective To evaluate the cardiovascular risk and related risk factors between patients with poorly controlled and patients with well-controlled type 2 diabetes mellitus in the next 10 years.Methods Five hundred and forty-nine diabetic patients enrolled in the study.According to levels of fasting hemoglobin A1c(HbA1c)on the second day after admission,they were divided into poorly controlled diabetes group(HbA1c>7%)(n=408),and well-controlled diabetes group(HbA1c≤7%)(n=141).The following data and parameters were monitored:age,gender,residence,smoking and alcohol consumption,diseases history,body mass index,waist circumference,systolic blood pressure,diastolic blood pressure,blood glucose,total cholesterol,triglycerides,low-density lipoprotein(LDL),high-density lipoprotein and fibrinogen(P<0.05).Framingham Rish Score and China-PAR were used to predict the risk of cardiovascular diseases over the next decade.Results Systolic blood pressure,diastolic blood pressure,fasting glucose,total cholesterol,mean LDL cholesterol are statistically significant higher in patients with poorly controlled diabetes.Framingham 10-year cardiovascular event risk assessment model and China-PAR shows that most of patients with poorly controlled type 2 diabetes mellitus have a high cardiovascular risk.Conclusion Patients with poorly controlled diabetes should pay more attention to monitoring and controlling of cardiovascular risk factors to reduce their cardiovascular risk.

关 键 词：糖尿病 血糖水平 心血管病风险 心血管病危险因素 

分 类 号：R587.2[医药卫生—内分泌] R54[医药卫生—内科学]