摘要
目的探究血糖控制方式、糖脂代谢水平及抗凝治疗对2型糖尿病(T2DM)合并冠心病经皮冠脉介入治疗(PCI)术后患者预后的影响。方法选取2019年5月—2020年5月福建医科大学附属协和医院心外科收治的T2DM合并冠心病患者190例作为研究组,根据血糖控制方式进行分组,饮食控制组52例,口服降糖药物组107例,注射胰岛素组31例。同时收集其他慢性病患者80例作为观察组。观察记录不良心血管事件发生的情况:复发心绞痛、非致死心肌梗死、冠脉病变重构,并使用Fisher确切概率法进行统计分析。根据研究组预后情况分为预后良好组157例,预后不良组33例。抽取空腹外周静脉血,检测空腹血糖(GLU)、糖化血红蛋白(HbA1c)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、三酰甘油(TG)、总胆固醇(TC)、脂蛋白(Lpa)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、国际化标准值(INR)。记录分析患者的人口学特征及临床相关研究资料,包括性别、年龄。对差异有统计学意义的多因素进行二元Logistic回归分析。结果心血管不良事件在不同血糖控制组中的发生率差异有统计学意义(P<0.05)。研究组与观察组相比,心血管不良事件的发生率,差异有统计学意义(P<0.05)。男性、GLU、LDL-C、TC、HbA1c、PT和INR在预后不良组的水平较预后良好组高,差异有统计学意义(P<0.05)。HbA1c对预后不存在显著性影响(P>0.05),血糖、LDL-C、TC、PT和INR对冠心病术后预后存在显著性影响(P<0.05)。结论不同血糖控制方式及血脂代谢异常是2型糖尿病合并冠心病PCI预后的主要影响因素,抗凝疗效的不同也会对PCI的预后产生影响。
Objective To explore the effect of glycemic lipid level and anticoagulant effect on prognosis of type 2 diabetes mellitus(T2 DM) combined with coronary heart disease(CHD) with coronary heart disease(PCI).Methods 190 patients with T2 DM complicated with coronary heart disease treated in the department of cardiac surgery,Union Hospital Affiliated to Fujian Medical University from May 2019 to May 2020 were selected as the study group.They were divided into 52 cases in the diet control group,107 cases in the oral hypoglycemic drug group and 31 cases in the insulin injection group.At the same time,80 patients with other chronic diseases were collected as the observation group.The occurrence of adverse cardiovascular events:recurrent angina pectoris,nonfatal myocardial infarction,coronary lesion remodeling were observed and recorded,and the Fisher exact probability method was used for statistical analysis.According to the prognosis of the study group,157 cases were divided into good prognosis group and 33 cases were divided into poor prognosis group.Fasting peripheral venous blood was taken to detect fasting blood glucose(GLU),glycosylated hemoglobin(HbA1 c),high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),triacylglycerol(TG),total cholesterol(TC),lipoprotein(LPA),prothrombin time(PT),activated partial thromboplastin time(APTT) and international standard value(INR).The demographic characteristics and clinical research data of patients were recorded and analyzed,including gender and age.The multiple factors with statistical difference were analyzed by binary Logistic regression.Results The incidence rate of cardiovascular adverse events in different glycemic control groups was statistically significant difference(P<0.05).There was statistically significant difference in the incidence of cardiovascular adverse events between the study group and the observation group(P<0.05).The levels of male,GLU,LDL-C,TC,HbA1 c,PT and INR in the poor prognosis group were higher than those in the good prognosis group,the difference was statistically significant(P<0.05).HbA1 c had no significant effect on the prognosis(P>0.05).Blood glucose,LDL-C,TC,PT and INR had significant effects on the prognosis of coronary heart disease(P<0.05).Conclusion Different glycemic control methods and abnormal lipid metabolism are the main prognostic factors of type 2 diabetes mellitus combined with coronary heart disease,and the different anticoagulation effects will also affect the prognosis of PCI.
作者
高文萍
GAO Wenping(Department of Cardiac Surgery,Union Hospital,Fujian Medical University,Fuzhou,Fujian Province,350001 China)
出处
《糖尿病新世界》
2021年第19期26-29,33,共5页
Diabetes New World Magazine
关键词
2型糖尿病
冠心病
血糖控制方式
糖脂代谢
Type 2 diabetes mellitus
Coronary heart disease
Blood glucose control mode
Glucose and lipid metabolism
