本文選題：糖尿病　切入點(diǎn)：糖尿病并發(fā)癥　出處：《中華老年心腦血管病雜志》2016年11期

【摘要】：目的探討血管緊張素轉(zhuǎn)換酶(ACE)對(duì)糖尿病合并高血壓患者心腦血管事件的預(yù)測(cè)價(jià)值。方法選擇糖尿病合并高血壓患者312例,根據(jù)ACE水平分為ACE較高組157例和ACE較低組155例,測(cè)定基線ACE水平、收集基線資料后平均隨訪73.3個(gè)月,比較2組心腦血管事件發(fā)生情況。結(jié)果 ACE較高組腦梗死(14.66/千人年vs5.30/千人年)和總心腦血管事件(24.08/千人年vs 9.53/千人年)發(fā)生率明顯高于ACE較低組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。2組心肌梗死(4.19/千人年vs 2.12/千人年)、心源性猝死(2.09/千人年vs 1.06/千人年)和腦出血(3.14/千人年vs 1.06/千人年)發(fā)生率比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。采用Cox比例風(fēng)險(xiǎn)回歸模型分析顯示,校正協(xié)變量后,ACE水平較高仍是總心腦血管事件的危險(xiǎn)因素(RR=1.27,95%CI:1.04~3.18,P=0.042)。結(jié)論糖尿病合并高血壓患者中ACE水平升高是心腦血管事件發(fā)生的危險(xiǎn)因素。
[Abstract]:Objective to investigate the value of angiotensin converting enzyme (ACE) in predicting cardiovascular and cerebrovascular events in diabetic patients with hypertension. Methods 312 diabetic patients with hypertension were divided into higher ACE group (157 cases) and lower ACE group (155 cases). The baseline ACE level was measured and the baseline data were collected and followed up for an average of 73.3 months. Results the incidence of cerebral infarction and total cardiovascular events in the ACE group was significantly higher than that in the lower ACE group (14.66 / 1000 vs5.30/ per year) and 24.08 / 1000 person year vs 9.53 / 1000 person year respectively, and the incidence of cardiovascular and cerebrovascular events in the two groups was significantly higher than that in the lower ACE group. There were significant differences in the incidence of myocardial infarction (4.19 / 1000 person years vs 2.12 / 1000 person years, sudden cardiac death 2.09 / 1000 years vs 1.06 / 1000 person years) and intracerebral hemorrhage (3.14 / 1000 person years vs 1.06 / 1000 person years). The difference was not statistically significant (P 0.05). The Cox proportional risk regression analysis showed that, The higher level of ACE is still the risk factor of total cardiovascular and cerebrovascular events. Conclusion the increase of ACE level in diabetic patients with hypertension is a risk factor of cardiovascular and cerebrovascular events.
【作者單位】： 華北理工大學(xué)附屬醫(yī)院神經(jīng)外科;華北理工大學(xué)公共衛(wèi)生學(xué)院;
【基金】：河北省醫(yī)學(xué)科學(xué)研究重點(diǎn)課題計(jì)劃(ZD20140173)
【分類號(hào)】：R544.1;R587.1

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