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中老年糖尿病合并高血压患者心脑血管事件发生情况分析
作者:马志刚 左庆瑶 
单位:100035 北京积水潭医院神经内科(马志刚) 内分泌科(左庆瑶) 
关键词:糖尿病 高血压 心血管疾病 脑血管疾病 
分类号:R 589
出版年,卷(期):页码:2017,12(9):1306-1309
摘要:

【摘要】目的    分析中老年糖尿病合并高血压患者心脑血管事件发生情况。方法    选择2010年 1月至2014年12月于北京积水潭医院就诊的中老年糖尿病和高血压患者1 125例作为观察组。根据疾病类型的不同,将患者分为糖尿病组(358例)、高血压组(401例)和糖尿病合并高血压组(366例)。选择同期本院体格检查的376名受试者作为对照组。分析中老年糖尿病合并高血压患者心脑血管事件和全因死亡发生情况。结果    随访5年后,总心脑血管事件91例,全因死亡35例。观察组心脑血管事件86例,对照组心脑血管事件5例;观察组全因死亡31例,对照组全因死亡4例。经过Log-rank法检验,观察组心肌梗死、脑梗死、脑出血、心脑血管事件、全因死亡发生率明显高于对照组[2.0%(23/1 125)比0.3%(1/376)、3.7%(42/1 125)比0.8%(3/376)、1.9%(21/1 125)比0.3%(1/376)、7.6%(86/1 125)比1.3%(5/376)、2.8%(31/1 125)比1.1%(4/376)];糖尿病合并高血压组心脑血管事件和全因死亡发生率明显高于对照组、糖尿病组和高血压组[12.6%(46/366)比1.3%(5/376)、6.7%(24/358)、4.0%(16/401);4.1%(15/366)比1.1%(4/376)、2.8%(10/358)、1.5%(6/401)],差异均有统计学意义(均P<0.05)。结论    中老年糖尿病合并高血压患者心脑血管事件和全因死亡发生率明显高于糖尿病、高血压患者和对照组受试者;此外,糖尿病患者心肌梗死和脑梗死发生率高于高血压患者,而脑出血发生率低于高血压患者。

Cardiovascular and cerebrovascular events in middle and old age patients suffering from diabetes mellitus complicated with hypertension
Ma Zhigang, Zuo Qingyao
Department of Neurology, Beijing Jishuitan Hospital, Beijing 100035, China(Ma ZG); Department of Endocrinology, Beijing Jishuitan Hospital, Beijing 100035, China(Zuo QY)
Corresponding author: Ma Zhigang, Email: mzg0221@sina.com
【Abstract】Objective    To analyze the incidence of cardiovascular and cerebrovascular events in middle and old age patients suffering from diabetes complicated with hypertension. Methods    Totally 1 125 middle and old age patients with diabetes and hypertension from January 2010 to December 2014 in Beijing Jishuitan Hospital were enrolled as observation group; they were divided into diabetes group(358 cases), hypertension group(401 cases) and diabetes complicated with hypertension group(366 cases). A total of 376 physical examination people were enrolled as control group. The incidence of cardio-cerebrovascular events and all-cause mortality were analyzed. Results    During 5-year follow-up, there were 91 cases of cardio-cerebrovascular events and 35 cases of all-cause death in total. The observation group had 86 cases of cardio-cerebrovascular events and 31 cases of all-cause death. The control group had 5 cases of cardio-cerebrovascular events and 4 cases of all-cause death. Log-rank test showed that incidences of myocardial infarction, cerebral infarction, cerebral hemorrhage, total cardio-cerebrovascular events and the all-cause mortality in observation group were significantly higher than those in control group[2.0%(23/1 125) vs 0.3%(1/376), 3.7%(42/1 125) vs 0.8%(3/376), 1.9%(21/1 125) vs 0.3%(1/376), 7.6%(86/1 125) vs 1.3%(5/376), 2.8%(31/1 125) vs 1.1%(4/376)](P<0.05). Incidences of cardio-cerebrovascular events and all-cause mortality in diabetes complicated with hypertension group were significantly higher than those in control group, diabetes group and hypertension group[12.6%(46/366) vs 1.3%(5/376), 6.7%(24/358), 4.0%(16/401); 4.1%(15/366) vs 1.1%(4/376), 2.8%(10/358), 1.5%(6/401)](P<0.05). Conclusion    Middle and old age patients suffering from diabetes complicated with hypertension have high incidence of cardio-cerebrovascular events and high all-cause mortality; incidences of myocardial infarction and cerebral infarction in patients with diabetes are higher than those in patients with hypertension; the incidence of cerebral hemorrhage in patients with hypertension is higher than that in patients with diabetes.
【Key words】Diabetes mellitus;Hypertension;Cardiovascular diseases;Cerebrovascular diseases

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参考文献:

[1]陈研,陈刚.中国糖尿病发病率和检出率地域性差异—98 058例成年受试者数据多水平空间分析[J].创伤与急诊电子杂志,2015,3(4):81-83.
Chen Y, Chen G. Regional differences in prevalence and detection rates of diabetes mellitus in China-multilevel spatial analysis of 98 058 adult subjects[J]. Journal of Trauma and Emergency(Electronic Version), 2015,3(4):81-83.
[2]Wang J, Zhang L, Wang F, et al. Prevalence, awareness, treatment, and control of hypertension in China: Results     from a national survey[J]. Am J Hypertens, 2014,27(11):1355-1361. DOI : 10.1093/ajh/hpu053.
[3]Afsharian S, Akbarpour S, Abdi H, et al. Risk factors for cardiovascular disease and mortality events in adults with type 2 diabetes—a 10-year follow-up: tehran lipid and glucose study[J]. Diabetes Metab Res Rev, 2016,32(6):596-606. DOI: 10.1002/dmrr.2776.
[4]Sardarinia M, Akbarpour S, Lotfaliany M, et al. Risk factors for incidence of cardiovascular diseases and all-cause mortality in a middle eastern population over a decade follow-up: tehran lipid and glucose study[J]. PLoS One, 2016,11(12):e0167623. DOI: 10.1371/journal.pone.0167623.
[5]Quintanilla-García C, Zúiga-Guajardo S. The incretin effect and type 2 diabetes[J]. Rev Med Inst Mex Seguro Soc, 2010,48(5):509-520.
[6]《中国高血压基层管理指南》修订委员会.中国高血压基层管理指南(2014年修订版)[J].中华健康管理学杂志,2015,9(1):10-30. DOI: 10.3760/cma.j.issn.1674-0815.2015.01.004.
Revision Committee of Chinese Guidelines for Management of Hypertension. Chinese guidelines for management of hypertension(2014 revised edition)[J]. Chinese Journal of Health Management, 2015,9(1):10-30. DOI: 10.3760/cma.j.issn.1674-0815.2015.01.004.
[7]范书英.2015年《中国急性ST段抬高型心肌梗死(STEMI)诊断治疗指南》要点解读[J].中国全科医学,2015,18(27):3268-3269,3275. DOI: 10.3969/j.issn.1007-9572.2015.27.003.
Fan SY. 2015 Chinese guideline for the diagnosis and treatment of acute STEMI[J]. Chinese General Practice, 2015,18(27):3268-3269,3275. DOI: 10.3969/j.issn.1007-9572.2015.27.003.
[8]卫生部疾病控制司,中华医学会神经病学分会.中国脑血管病防治指南(节选)[J].中国现代神经疾病杂志,2007,7(2):200. DOI: 10.3969/j.issn.1672-6731.2007.02.027.
Disease Control in Ministry of Health, Chinese Society of Neurology. Chinese guidelines for the prevention and treatment of cerebrovascular diseases(excerpt)[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2007,7(2):200. DOI: 10.3969/j.issn.1672-6731.2007.02.027.
[9]汪奇柏,郑超,何建国,等.高血压脑出血的高危因素调查及应用研究[J].中国临床医生杂志,2017,45(2):50-53. DOI: 10.3969/j.issn.2095-8552.2017.02.018.
Wang QB, Zheng C, He JG, et al. The application research and high risk factor investigation of hypertensive intracerebral hemorrhage[J]. Chinese Journal for Clinicians, 2017,45(2):50-53. DOI: 10.3969/j.issn.2095-8552.2017.02.018.
[10]李慧英.糖尿病患者心血管事件危险因素的临床分析[J].中国临床医生杂志,2015,43(6):52-53. DOI: 10.3969/j.issn.2095-8552.2015.06.021.
Li HY. Clinical analysis of risk factors of cardiovascular events in diabetes mellitus patients[J]. Chinese Journal for Clinicians, 2015,43(6):52-53. DOI: 10.3969/j.issn.2095-8552.2015.06.021.
[11]Lu CH, Tsai ML, Chen CC, et al. Comparison of very long-term clinical and angiographic outcomes of bare metal stent implants between patients with and without type 2 diabetes[J]. Prim Care Diabetes, 2017. DOI: 10.1016/j.pcd.2017.04.006.
[12]Thabet AM, Kottapally M, Hemphill JC 3rd. Management of intracerebral hemorrhage[J]. Handb Clin Neurol, 2017(140):177-194. DOI: 10.1016/B978-0-444-63600-3.00011-8.
[13]An SJ, Kim TJ, Yoon BW. Epidemiology, risk factors, and clinical features of intracerebral hemorrhage: an update[J]. J Stroke, 2017,19(1):3-10. DOI: 10.5853/jos.2016.00864.

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