青岛地区糖尿病合并冠心病患者发生心肌损伤的流行病学特征及危险因素  

Epidemiological characteristics and risk factors of myocardial injury in patients with diabetes mellitus complicated with coronary heart disease in Qingdao area

作　　者：吕鑫 张文忠[1] LYU Xin;ZHANG Wenzhong(Department of Cardiology,Affiliated Hospital of Qingdao University,Qingdao,Shandong 266000,China)

机构地区：[1]青岛大学附属医院心内科,山东青岛266000

出　　处：《公共卫生与预防医学》2023年第5期145-148,共4页Journal of Public Health and Preventive Medicine

摘　　要：目的分析青岛地区糖尿病合并冠心病患者发生心肌损伤的流行病学特征及危险因素,为糖尿病合并冠心病患者预防发生心肌损伤提供理论依据。方法选取2019年6月至2020年6月青岛大学附属医院收治的糖尿病合并冠心病患者196例,根据患者住院期间是否发生心肌损伤分为心肌损伤组(n=39)和无心肌损伤组(n=157),抽取所有研究对象空腹肘静脉血4 mL,对比两组血清cTnT、BNP和CK-MB水平,从病历系统收集患者临床资料,包括患者性别、年龄、服用降脂药史、BMI、糖尿病、冠心病病程及血清TG、FPG、PBG、HbAlc、HDL-C、LDL-C水平等,采用单因素分析和logistic回归分析影响糖尿病合并冠心病患者发生心肌损伤的影响因素。结果196例糖尿病合并冠心病患者中发生心肌损伤39例(19.90%),其中男性21例,女性18例;两组间性别间差异无统计学意义(χ^(2)=0.105,P>0.05);心肌损伤组患者年龄(64.78±5.67)明显高于对照组(59.72±5.12)(t=5.016,P<0.05);心肌损伤组患者血清cTnT、BNP和CK-MB水平明显高于对照组(P<0.05);两组在冠心病病程、血清Hcy、TG、FPG、PBG、HbAlc、TG、LDL-C间差异有统计学意义(P<0.05);Hcy升高(OR=2.673)、FBG升高(OR=3.681)、LDL-C升高(OR=2.912)是影响糖尿病合并冠心病患者发生心肌损伤的危险因素(P<0.05)。结论青岛地区糖尿病合并冠心病患者发生心肌损伤的风险较高,与患者的餐后LDL-C升高、FBG及Hcy升高密切相关,应给予积极干预,可降低发生心肌损伤的风险。Objective To analyze the epidemiological characteristics and risk factors of myocardial injury in diabetes patients with coronary heart disease in Qingdao,and to provide a theoretical basis for the prevention of myocardial injury in diabetes patients with coronary heart disease.Methods A total of 196 diabetes patients with coronary heart disease admitted to the Affiliated Hospital of Qingdao University from June 2019 to June 2020 were selected.The patients were divided into myocardial injury group(n=39)and non-myocardial injury group(n=157)according to whether myocardial injury occurred during hospitalization.Four ml of fasting elbow venous blood was collected from all subjects.The serum cTnT,BNP and CK-MB levels of the two groups were compared.The clinical data of the patients were collected from the medical record system,including gender,age,history of taking lipid-lowering drugs,BMI,diabetes mellitus,course of coronary heart disease and serum TG,FPG,PBG,HbAlc,HDL-C,LDL-C levels,etc.Univariate analysis and logistic regression analysis were used to analyze the influencing factors of myocardial injury in patients with diabetes mellitus complicated with coronary heart disease.Results Among of 196 diabetic patients with coronary heart disease,39 cases(19.90%)had myocardial injury,including 21 males and 18 females.There was no difference in gender between the two groups(X^(2)=0.105,P>0.05).The age of patients in the myocardial injury group(64.78±5.67)was significantly higher than that in the control group(59.72±5.12)(t=5.016,P<0.05).The serum levels of cTnT,BNP and CK-MB in the myocardial injury group were significantly higher than those in the control group(P<0.05).There were significant differences in the course of coronary heart disease,serum Hcy,TG,FPG,PBG,HbAlc,TG and LDL-C between the two groups(P<0.05).Increased Hcy(OR=2.673),increased FBG(OR=3.681)and increased LDL-C(OR=2.912)were risk factors for myocardial injury in patients with diabetes mellitus complicated with coronary heart disease(P<0.05).Conclusio

关 键 词：糖尿病 冠心病 心肌损伤 流行病学特征 

分 类 号：R181[医药卫生—流行病学]