中国全科医学
中國全科醫學
중국전과의학
CHINESE GENERAL PRACTICE
2014年
20期
2317-2320
,共4页
王志军%周建芝%张放%张志强%李海涛%葛庆峰%吴寿岭
王誌軍%週建芝%張放%張誌彊%李海濤%葛慶峰%吳壽嶺
왕지군%주건지%장방%장지강%리해도%갈경봉%오수령
糖尿病,2型%高血压%危险因素%随访研究 Diabetesmellitus,type2%Hypertension%Riskfactors%Follow-upstudies
糖尿病,2型%高血壓%危險因素%隨訪研究 Diabetesmellitus,type2%Hypertension%Riskfactors%Follow-upstudies
당뇨병,2형%고혈압%위험인소%수방연구 Diabetesmellitus,type2%Hypertension%Riskfactors%Follow-upstudies
Diabetes mellitus,type 2%Hypertension%Risk factors%Follow - up studies
目的:分析血压正常的2型糖尿病( T2Dm)患者合并正常高值血压的患病率及其危险因素,评价正常高值血压对T2Dm患者肾功能的影响。方法应用回顾性分析与前瞻性研究相结合的方法,选取3481例血压正常的T2Dm患者作为研究对象,根据血压水平分为正常血压组和正常高值血压组。随访5年,比较正常血压组和正常高值血压组新发高血压的累计发病率,并分析T2Dm合并正常高值血压发生高血压的影响因素。应用Excel数据库建库,采用SPSS 13.0软件进行统计学分析。结果正常血压组943例(27.1%),正常高值血压组2538例(72.9%)。正常高值血压组男性多于正常血压组,打鼾率、吸烟率高于正常血压组,三酰甘油( TG)、低密度脂蛋白胆固醇( LDL-C)、体质指数(BmI)高于正常血压组(P﹤0.05);两组其余指标间差异无统计学意义(P﹥0.05)。多因素Logistic回归分析结果显示:男性、打鼾、吸烟及高水平的TG、LDL-C、BmI与正常高值血压有关( OR=1.622、1.304、1.428、1.085、1.341、1.092,P﹤0.05)。正常高值血压组肾功能不全发生率为38.3%,高于正常血压组的33.8%(χ2=6.761,P=0.009)。随访5年后,剔除死亡患者,正常高值血压组实际随访2471例,正常血压组实际随访899例;正常高值血压组高血压累计发病率为35.8%(885/2471),低于正常血压组的22.0%(198/899)(χ2=57.486,P﹤0.05)。男性、女性正常高值血压患者高血压累计发病率分别为36.7%和31.5%,超重和非超重患者高血压累计发病率分别为39.4%和31.3%,差异均有统计学意义(χ2=4.070、17.255,P﹤0.05)。结论男性、打鼾、吸烟及高水平的TG、LDL-C、BmI是T2Dm合并正常高值血压的危险因素。正常高值血压是促进T2Dm患者肾功能不全的危险因素。T2Dm合并正常高值血压患者5年高血压累计发病率明显高于正常血压者。男性和超重为T2Dm合并正常高值血压患者发生高血压的危险因素。应进一步强化对T2Dm合并正常高值血压患者多种危险因素的综合防治,以改善患者预后。
目的:分析血壓正常的2型糖尿病( T2Dm)患者閤併正常高值血壓的患病率及其危險因素,評價正常高值血壓對T2Dm患者腎功能的影響。方法應用迴顧性分析與前瞻性研究相結閤的方法,選取3481例血壓正常的T2Dm患者作為研究對象,根據血壓水平分為正常血壓組和正常高值血壓組。隨訪5年,比較正常血壓組和正常高值血壓組新髮高血壓的纍計髮病率,併分析T2Dm閤併正常高值血壓髮生高血壓的影響因素。應用Excel數據庫建庫,採用SPSS 13.0軟件進行統計學分析。結果正常血壓組943例(27.1%),正常高值血壓組2538例(72.9%)。正常高值血壓組男性多于正常血壓組,打鼾率、吸煙率高于正常血壓組,三酰甘油( TG)、低密度脂蛋白膽固醇( LDL-C)、體質指數(BmI)高于正常血壓組(P﹤0.05);兩組其餘指標間差異無統計學意義(P﹥0.05)。多因素Logistic迴歸分析結果顯示:男性、打鼾、吸煙及高水平的TG、LDL-C、BmI與正常高值血壓有關( OR=1.622、1.304、1.428、1.085、1.341、1.092,P﹤0.05)。正常高值血壓組腎功能不全髮生率為38.3%,高于正常血壓組的33.8%(χ2=6.761,P=0.009)。隨訪5年後,剔除死亡患者,正常高值血壓組實際隨訪2471例,正常血壓組實際隨訪899例;正常高值血壓組高血壓纍計髮病率為35.8%(885/2471),低于正常血壓組的22.0%(198/899)(χ2=57.486,P﹤0.05)。男性、女性正常高值血壓患者高血壓纍計髮病率分彆為36.7%和31.5%,超重和非超重患者高血壓纍計髮病率分彆為39.4%和31.3%,差異均有統計學意義(χ2=4.070、17.255,P﹤0.05)。結論男性、打鼾、吸煙及高水平的TG、LDL-C、BmI是T2Dm閤併正常高值血壓的危險因素。正常高值血壓是促進T2Dm患者腎功能不全的危險因素。T2Dm閤併正常高值血壓患者5年高血壓纍計髮病率明顯高于正常血壓者。男性和超重為T2Dm閤併正常高值血壓患者髮生高血壓的危險因素。應進一步彊化對T2Dm閤併正常高值血壓患者多種危險因素的綜閤防治,以改善患者預後。
목적:분석혈압정상적2형당뇨병( T2Dm)환자합병정상고치혈압적환병솔급기위험인소,평개정상고치혈압대T2Dm환자신공능적영향。방법응용회고성분석여전첨성연구상결합적방법,선취3481례혈압정상적T2Dm환자작위연구대상,근거혈압수평분위정상혈압조화정상고치혈압조。수방5년,비교정상혈압조화정상고치혈압조신발고혈압적루계발병솔,병분석T2Dm합병정상고치혈압발생고혈압적영향인소。응용Excel수거고건고,채용SPSS 13.0연건진행통계학분석。결과정상혈압조943례(27.1%),정상고치혈압조2538례(72.9%)。정상고치혈압조남성다우정상혈압조,타한솔、흡연솔고우정상혈압조,삼선감유( TG)、저밀도지단백담고순( LDL-C)、체질지수(BmI)고우정상혈압조(P﹤0.05);량조기여지표간차이무통계학의의(P﹥0.05)。다인소Logistic회귀분석결과현시:남성、타한、흡연급고수평적TG、LDL-C、BmI여정상고치혈압유관( OR=1.622、1.304、1.428、1.085、1.341、1.092,P﹤0.05)。정상고치혈압조신공능불전발생솔위38.3%,고우정상혈압조적33.8%(χ2=6.761,P=0.009)。수방5년후,척제사망환자,정상고치혈압조실제수방2471례,정상혈압조실제수방899례;정상고치혈압조고혈압루계발병솔위35.8%(885/2471),저우정상혈압조적22.0%(198/899)(χ2=57.486,P﹤0.05)。남성、녀성정상고치혈압환자고혈압루계발병솔분별위36.7%화31.5%,초중화비초중환자고혈압루계발병솔분별위39.4%화31.3%,차이균유통계학의의(χ2=4.070、17.255,P﹤0.05)。결론남성、타한、흡연급고수평적TG、LDL-C、BmI시T2Dm합병정상고치혈압적위험인소。정상고치혈압시촉진T2Dm환자신공능불전적위험인소。T2Dm합병정상고치혈압환자5년고혈압루계발병솔명현고우정상혈압자。남성화초중위T2Dm합병정상고치혈압환자발생고혈압적위험인소。응진일보강화대T2Dm합병정상고치혈압환자다충위험인소적종합방치,이개선환자예후。
To analyze the prevalence of type 2 diabetes mellitus(T2Dm)combined with high normal blood pressure(BP)and its risk factors,to evaluate the effects of high normal BP on kidney function of T2Dm patients. Meth-ods Atotalof3481T2DmpatientswithnormalBPweredivided,accordingtoBPlevel,intogroupsA(withnormalBP),B (with high normal BP). After 5-year follow-up,the cumulative incidences of new-onset hypertension were compared be-tween 2 groups,the influencing factors of hypertension occurrence in patients with T2mD combined with high normal BP. Excelldatabasewasusedtobuilddatabase,SPSS13.0softwareusedtoperformstatisticalanalysis.Results Therewere943patients in group A(27.1%),2538 in group B(72.9%). male patients were more,rates of snore and smoking higher,levels of TG,LDL-C,BmI higher in group B than in group A(P﹤0.05);there was no significant difference in other indexes between 2 groups(P﹥0.05). multivariate Logistic regression analysis showed that males,snore,smoking,high levels of TG,LDL-C,BmI were related to high normal BP(OR=1.622,1.304,1.428,1.085,1.341,1.092,P﹤0.05). The incidence of renal inadequacy was 38.3% in group B,higher than in group A(33.8%)(χ2=6.761,P=0.009). After 5-year follow-up,2471 patients were followed up actually in group B,899 in group A;the cumulative incidence of hypertension was 35.8%(885/2471)in group B,lower than group A(22.0%,198/899)(χ2=57.486,P ﹤0.05),and 36.7% in males,31.5% in females in group B,and 39.4% in overweight patients,31.3% in non-overweight,the difference was sig-nificant(χ2=4.070,17.255,P﹤0.05).Conclusion male,snore,smoking,highlevelsofTG,LDL-C,BmIarerisk factors of T2Dm combined with high normal BP. High normal BP is a risk factor promoting T2Dm patients with renal inadequacy. male,overweight are risk factors of hypertension in high normal BP patients. Comprehensive prevention and control should be strengthened to improve patients′prognoses in T2Dm patients with high normal BP.