本文選題：老年患者　切入點：糖尿病　出處：《第三軍醫(yī)大學》2015年碩士論文　論文類型：學位論文

【摘要】：目的研究糖尿病老年患者血清胱抑素C水平與高血壓發(fā)病的相關性,探討血清胱抑素C水平與老年糖尿病合并高血壓發(fā)病的關系。方法收集2013年1月~2014年8月期間資料完整的在第三軍醫(yī)大學附屬第一醫(yī)院(西南醫(yī)院)老年科住院患者538例,依據(jù)患者是否患有高血壓分為高血壓組(347例)、非高血壓組(191例)兩組。收集所選患者的基本臨床資料,其中包括性別、年齡、身體質量指數(shù)(BMI)、血壓、血脂、血肌酐、血清胱抑素C、N末端B型利鈉肽原(NT-ProBNP)、高敏C反應蛋白(hs-CRP)、空腹血糖和糖化血紅蛋白。統(tǒng)計分析應用SPSS 19.0統(tǒng)計軟件進行。其中計量資料用±s表示,進行正態(tài)性、方差齊性檢驗,其中各組間方差齊性且符合正態(tài)性分布的計量資料,采用單因素方差分析;而不符合正態(tài)分布的計量資料,采用Mann-Whitney非參數(shù)檢驗。計數(shù)資料采用檢驗。結果2組間性別比例、血脂情況、血肌酐、血清胱抑素C、NT-ProBNP、hs-CRP、空腹血糖水平和糖化血紅蛋白無顯著差異。依據(jù)高血壓分級,將高血壓患者分成3個組,即高血壓1級組、高血壓2級組和高血壓3級組。與對照組比較,高血壓3級組的患者在年齡、BMI指數(shù)、收縮壓、舒張壓、血清胱抑素C、NT-ProBNP、hs-CRP水平上均明顯增高,差別有統(tǒng)計學差異(p0.05)。同樣與對照組(非高血壓組)比較,高血壓1級組和高血壓2級組患者的收縮壓、舒張壓水平呈現(xiàn)明顯增高(p0.05);而與高血壓1級組患者比較,高血壓3級組患者血清胱抑素C水平呈顯著增高(p0.05)。運用Spearman相關分析提示,患者年齡、吸煙情況、BMI指數(shù)、肌酐、血清胱抑素C、NT-ProBNP與高血壓具有相關性。運用多元logistic回歸分析提示患者年齡、吸煙情況、BMI指數(shù)和血清胱抑素C與高血壓發(fā)病具有相關性。再設置血清胱抑素C水平為因變量,運用Spearman相關分析統(tǒng)計各個危險因數(shù)與血清胱抑素C水平相關性,結果提示各種危險因素當中,與糖尿病老年患者血漿血清胱抑素C水平具有相關性的有患者年齡、性別、吸煙情況、收縮壓、TC、LDL-c、HDL-c、肌酐水平、NT-proBNP以及hs-CRP。結論伴隨糖尿病老年患者血清胱抑素C水平的上升,高血壓的發(fā)生率有增高趨勢,揭示血清胱抑素C有可能是老年糖尿病患者合并高血壓的獨立危險因素。血清胱抑素C的升高與高脂、炎癥狀態(tài)有關,提示血清胱抑素C可能共同參與血管粥樣硬化等病變及發(fā)病。
[Abstract]:Objective to study the correlation between serum cystatin C level in elderly patients with diabetes and hypertension, to explore the relationship between serum cystatin C level and elderly diabetic patients with hypertension. Methods from January 2013 August ~2014 data in the First Affiliated Hospital of Third Military Medical University (Southwest Hospital) in 538 cases of hospitalized elderly families, according to whether patients with hypertension were divided into hypertension group (347) and non hypertension group (191 cases) in two groups. The collection of basic clinical data were selected, including gender, age, body mass index (BMI), blood pressure, blood lipid, serum creatinine, serum cystatin C, N terminal B type natriuretic peptide (NT-ProBNP), high sensitive C reactive protein (hs-CRP), fasting blood glucose and glycosylated hemoglobin. Statistical analysis was performed using SPSS 19 statistical software. The measurement data is represented by + s, normality, homogeneity of variance test, which were square The difference is homogeneous and in accordance with the measurement data of normal distribution, using the single factor analysis of variance; and does not conform to the normal distribution of the measurement data, using the Mann-Whitney non parametric test. Test with count data. Results among the 2 groups of sex ratio, blood lipid, serum creatinine, serum cystatin C, NT-ProBNP, hs-CRP, no significant difference fasting blood glucose levels and glycosylated hemoglobin. According to the grade of hypertension, hypertensive patients were divided into 3 groups: Grade 1 hypertension group, hypertension group and grade 2 grade 3 hypertension group. Compared with the control group, the patients with grade 3 hypertension group in age, BMI index, systolic blood pressure, diastolic blood pressure, serum cystatin C, NT-ProBNP. The level of hs-CRP increased significantly, the difference was statistically significant (P0.05). The same with the control group (non hypertension group), grade 1 hypertension group and hypertension grade 2 group of patients with systolic blood pressure, diastolic blood pressure levels showed significantly increased (P0.05); and high blood Pressure level 1 group of patients, grade 3 hypertension patients serum cystatin C levels were significantly higher (P0.05). Using the Spearman correlation analysis showed that age, smoking status, BMI index, serum creatinine, serum cystatin C, NT-ProBNP were associated with hypertension. Multivariate logistic regression analysis showed that age, smoking index, BMI and serum cystatin C and the incidence of hypertension is associated. And then set the level of serum cystatin C as the dependent variable, using the correlation Spearman correlation analysis statistics of each risk factor and the level of serum cystatin C, the results suggest a variety of risk factors, and the correlation between plasma levels of serum cystatin C in elderly patients with diabetes mellitus have included age, gender, smoking status. The systolic blood pressure, TC, LDL-c, HDL-c, NT-proBNP and creatinine levels, hs-CRP. increased with the conclusion in diabetic patients aged clear levels of cystatin C, high blood The trend rate of increase pressure, revealing the serum cystatin C may be independent risk factors for elderly patients with diabetes mellitus complicated with hypertension. With the increase of hyperlipidemic serum cystatin C, inflammatory status, serum cystatin C may be involved in atherosclerosis and other diseases and disease.

【學位授予單位】：第三軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R544.1;R587.1

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本文編號：1651171