【摘要】：目的:分析首次住院2型糖尿病(T2DM)合并冠心病患者的患病情況和分布特點,探討多種因素與T2DM合并冠心病的關(guān)系,為T2DM患者合并冠心病的篩查和預(yù)防控制工作提供科學(xué)依據(jù)。方法:回顧性分析2012年5月15日至2013年5月20日在天津醫(yī)科大學(xué)總醫(yī)院和代謝病醫(yī)院住院的T2DM患者的病歷資料,摘錄相關(guān)信息,內(nèi)容包括:人口統(tǒng)計學(xué)特征、疾病史、疾病家族史、行為方式、體格檢查及實驗室檢查資料,采用Epi Data軟件建立數(shù)據(jù)庫。以其中首次住院的T2DM患者作為研究對象,分析T2DM患者合并冠心病的患病率及其分布特點;采用病例對照方法,以T2DM合并冠心病者為病例組,未合并冠心病的T2DM患者為對照組,采用Logistic回歸分析方法對T2DM合并冠心病的相關(guān)因素進(jìn)行探討。結(jié)果:本研究的872例T2DM患者中有冠心病患者460例,T2DM患者中冠心病患病率為52.8%;冠心病的患病率女性高于男性,且隨著年齡的增長而增加。以T2DM合并冠心病患者460例作為病例組,未合并冠心病的T2DM患者412例作為對照組,單因素非條件Logistic回歸分析結(jié)果顯示:年齡大、女性、在婚、病程長、收縮壓及舒張壓高、糖尿病并發(fā)視網(wǎng)膜病變、糖尿病腎病、周圍神經(jīng)病變、高血壓、腦血管病變、頸動脈硬化、下肢動脈硬化以及高血壓家族史、冠心病家族史、尿素氮及肌酐與T2DM合并冠心病的高風(fēng)險有統(tǒng)計學(xué)關(guān)聯(lián),而現(xiàn)吸煙、現(xiàn)飲酒、空腹血糖、紅細(xì)胞增多及直接膽紅素與T2DM合并冠心病的低風(fēng)險有統(tǒng)計學(xué)關(guān)聯(lián);經(jīng)調(diào)整可能的混雜因素后,女性、在婚、現(xiàn)飲酒、現(xiàn)吸煙、空腹血糖、糖尿病并發(fā)視網(wǎng)膜病變、糖尿病腎病、周圍神經(jīng)病變、高血壓、腦血管病變、下肢動脈硬化及紅細(xì)胞增多、直接膽紅素與T2DM合并冠心病的統(tǒng)計學(xué)關(guān)聯(lián)消失。未發(fā)現(xiàn)糖尿病家族史、體質(zhì)指數(shù)、糖化血紅蛋白水平、糖尿病足、脂代謝紊亂、高粘血癥、高纖維蛋白原血癥、總膽固醇、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇及24h尿微量白蛋白、血小板、C反應(yīng)蛋白與T2DM合并冠心病存在統(tǒng)計學(xué)關(guān)聯(lián);但經(jīng)年齡、性別和糖尿病病程調(diào)整后,體質(zhì)指數(shù)與T2DM合并冠心病的高風(fēng)險有關(guān)。結(jié)論:T2DM患者合并冠心病的患病率為52.8%,女性患病率高于男性,患病率隨著年齡的增加而增加;糖尿病病程越長,T2DM患者合并冠心病的比例增加。年齡大、病程長、體質(zhì)指數(shù)高、收縮壓及舒張壓高、高血壓家族史、冠心病家族史、糖尿病合并頸動脈硬化、尿素氮及肌酐與T2DM合并冠心病的高風(fēng)險有關(guān);空腹血糖與與T2DM合并冠心病的低風(fēng)險有關(guān)。
[Abstract]:Objective: to analyze the prevalence and distribution characteristics of type 2 diabetes mellitus (T2DM) complicated with coronary heart disease (CHD) in the first hospitalization, and to explore the relationship between multiple factors and T2DM complicated with coronary heart disease (CHD). To provide scientific basis for screening, prevention and control of coronary heart disease in patients with T2DM. Methods: the medical records of T2DM patients hospitalized in Tianjin Medical University General Hospital and Metabolic Disease Hospital from May 15, 2012 to May 20, 2013 were analyzed retrospectively. Family history, behavior pattern, physical examination and laboratory examination data were established by Epi Data software. The prevalence and distribution characteristics of coronary heart disease (CHD) in patients with T2DM were analyzed with T2DM patients who were hospitalized for the first time. A case-control method was used to study the related factors of T2DM complicated with coronary heart disease (CHD) by Logistic regression analysis, taking the patients with T2DM with coronary heart disease (CHD) as the case group and the T2DM patients without CHD as the control group. Results: there were 460patients with coronary heart disease (CHD) among 872 patients with T2DM in this study, and the prevalence rate of CHD in T2DM patients was 52.8%, and the prevalence of CHD in females was higher than that in males and increased with the increase of age. The results of univariate non-conditional Logistic regression analysis showed that age, duration of marriage, long course of disease, high systolic and diastolic blood pressure (SBP) and diastolic blood pressure (DBP) were significantly higher than those of T2DM patients without coronary heart disease (CHD). The results of univariate non-conditional Logistic regression analysis showed that: 1. Diabetic retinopathy, Diabetic Nephropathy, Peripheral Neuropathy, Hypertension, Cerebral Vascular Disease, carotid Arteriosclerosis, Lower limb Arteriosclerosis and Family History of Hypertension, Coronary Heart Disease, Urea nitrogen and creatinine were significantly associated with the high risk of T2DM complicated with coronary heart disease, while smoking, drinking, fasting blood glucose, erythrocythemia and direct bilirubin were significantly associated with the low risk of T2DM complicated with coronary heart disease. Adjusted for possible confounding factors, women, married, drinking, smoking, fasting blood glucose, diabetic retinopathy, diabetic nephropathy, peripheral neuropathy, hypertension, cerebral angiopathy, Lower extremity arteriosclerosis and erythrocythemia, direct bilirubin and T2DM complicated with coronary heart disease statistical association disappeared. No family history of diabetes, body mass index, glycosylated hemoglobin level, diabetic foot, lipid metabolism disorder, hyperviscosity, hyperfibrinogenemia, total cholesterol, high density lipoprotein cholesterol, Low density lipoprotein cholesterol (LDL-C), 24-hour urinary microalbuminuria, platelet and C-reactive protein were associated with T2DM complicated with coronary heart disease (CHD). However, after adjusted for age, sex and diabetes duration, BMI was associated with a high risk of T2DM complicated with coronary heart disease. Conclusion: the prevalence of coronary heart disease in patients with T2DM is 52.8%, which is higher in women than in men and increases with age, and the longer the course of diabetes, the more the proportion of patients with T2DM complicated with coronary heart disease. Age, long course of disease, high body mass index, high systolic and diastolic blood pressure, family history of hypertension, family history of coronary heart disease, diabetes mellitus complicated with carotid atherosclerosis, urea nitrogen and creatinine were associated with the high risk of T2DM complicated with coronary heart disease. Fasting blood glucose is associated with a low risk of T2DM associated with coronary heart disease.
【學(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R587.1;R541.4

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