本文選題：型糖尿病　切入點：非酒精性脂肪性肝病　出處：《重慶醫(yī)科大學(xué)學(xué)報》2017年07期

【摘要】：目的:探討2型糖尿病合并非酒精性脂肪性肝病(non-alcoholic fatty liver disease,NAFLD)患者發(fā)生心房纖顫(atrial fibrillation,AF)的危險因素。方法:選取2010年9月至2014年6月我院2型糖尿病合并NAFLD患者共208例,收集一般臨床資料,常規(guī)檢查心電圖,腹部彩超,將入組患者分為房顫組和非房顫組,然后采用多因素logistic回歸模型篩選主要危險因素。結(jié)果:房顫組患者的體質(zhì)量指數(shù)、糖化血紅蛋白、總膽固醇(total cholesterol,TC)、低密度脂蛋白膽固醇、甘油三酯、谷草轉(zhuǎn)氨酶、谷氨酰轉(zhuǎn)肽酶水平明顯高于非房顫組(P0.05);同時,房顫組患者中有糖尿病家族史、脂肪肝家族史、吸煙比例亦明顯高于非房顫組(P0.01),且年齡明顯高于非房顫組患者(P0.01)。單因素logistic回歸分析表明:2型糖尿病合并NAFLD患者發(fā)生房顫與性別、年齡、體質(zhì)指數(shù)、糖尿病家族史、脂肪肝家族史、高血壓、糖化血紅蛋白、總膽固醇、低密度脂蛋白顯著相關(guān)(P0.05);多因素logistic回歸分析表明:僅年齡和TC是2型糖尿病合并NAFLD患者發(fā)生房顫的危險因素(OR=2.769,95%CI=1.329~5.769,P=0.007;OR=1.435,95%CI=1.027~2.014,P=0.005)。結(jié)論:年齡和TC是2型糖尿病合并NAFLD患者發(fā)生房顫的危險因素,對于2型糖尿病合并NAFLD的患者更應(yīng)注意對膽固醇的控制。
[Abstract]:Objective: to investigate the risk factors of atrial fibrillation (AF) in patients with type 2 diabetes mellitus with non-alcoholic fatty liver disease.Methods: from September 2010 to June 2014, 208 patients with type 2 diabetes mellitus complicated with NAFLD in our hospital were selected. The general clinical data, electrocardiogram (ECG) and abdominal color Doppler ultrasonography were collected. The patients were divided into atrial fibrillation group and non-atrial fibrillation group.Then the multivariate logistic regression model was used to screen the main risk factors.Results: the body mass index, glycosylated hemoglobin, total cholesterol total cholesterol (TC), low density lipoprotein cholesterol, triglyceride, aspartate aminotransferase and glutamyl transpeptidase levels in AF group were significantly higher than those in non-AF group (P 0.05).The family history of diabetes mellitus and fatty liver in AF group was higher than that in non-AF group (P 0.01), and the age was significantly higher than that in non-AF group (P 0.01).Univariate logistic regression analysis showed that atrial fibrillation and gender, age, body mass index, family history of diabetes, family history of fatty liver, hypertension, glycosylated hemoglobin, total cholesterol were found in patients with type 2 diabetes mellitus complicated with NAFLD.Conclusion: age and TC are risk factors for atrial fibrillation in patients with type 2 diabetes mellitus and NAFLD, and cholesterol control should be paid more attention to in patients with type 2 diabetes mellitus with NAFLD.
【作者單位】： 重慶市第三人民醫(yī)院消化內(nèi)科;
【分類號】：R541.75;R575.5;R587.1

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