中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
9期
928-931
,共4页
糖尿病%心血管病%危险因素%整体风险评估%弗雷明汉风险评分
糖尿病%心血管病%危險因素%整體風險評估%弗雷明漢風險評分
당뇨병%심혈관병%위험인소%정체풍험평고%불뢰명한풍험평분
Diabetes mellitus%Cardiovascular disease%Risk factors%Overall risk assessment%Framingham cardiac risk score
目的 探讨成人糖尿病患者可能发生心血管病的相关危险因素.方法 收集2008年1月至2013年12月在我院住院治疗,病历资料完整的年龄≥20岁的糖尿病患者557例.根据心血管病危险评估的主要危险因素对每一个体应用弗雷明汉风险评分方法进行评分及分层,＜10％为低危、10％～20％为中危、＞20％为高危.分析未来10年发生心血管病的相关危险因素.结果 最终纳入调查研究 的糖尿病患者共557例,全部为汉族,其中男275例,女282例;1型糖尿病患者79例(14.18％),2型糖尿病患者478例(85.82％).10年总体心血管病风险概率评估发现低危者103例(低危组),占18.5％、中危者91例(中危组),占16.3％、高危者195例(高危组),占35.0％,以前有心血管病者168例为心血管病组,占30.2％.(1)不同危险分层发生心血管病的危险因素特征:①糖尿病患者代谢综合征的患病率较高,甚至在低危组也达37.9％,高危组达60.5％;②高危组年龄(65.3 ±11.7)岁高于低危组(50.3±15.4)岁;③高危组收缩压(143.4±18.1)mmHg高于低危组(125.7±13.2) mmHg;④高危组血压达标者较少(32.3％);⑤高危组慢性肾病的患病率(21.5％)大大高于中危组(7.7％)和低危组(7.8％).(2)2型糖尿病(高危组31.6％)发生心血管病的整体风险高于1型糖尿病(高危组16.4％).(3)70～79岁范围高危组比例高达39.2％.结论 2型糖尿病患者整体发生心血管病的风险增大,代谢因素可能是增加长期风险的原因,对糖尿病患者的风险评估有利于增加针对性治疗的强度.
目的 探討成人糖尿病患者可能髮生心血管病的相關危險因素.方法 收集2008年1月至2013年12月在我院住院治療,病歷資料完整的年齡≥20歲的糖尿病患者557例.根據心血管病危險評估的主要危險因素對每一箇體應用弗雷明漢風險評分方法進行評分及分層,＜10％為低危、10％～20％為中危、＞20％為高危.分析未來10年髮生心血管病的相關危險因素.結果 最終納入調查研究 的糖尿病患者共557例,全部為漢族,其中男275例,女282例;1型糖尿病患者79例(14.18％),2型糖尿病患者478例(85.82％).10年總體心血管病風險概率評估髮現低危者103例(低危組),佔18.5％、中危者91例(中危組),佔16.3％、高危者195例(高危組),佔35.0％,以前有心血管病者168例為心血管病組,佔30.2％.(1)不同危險分層髮生心血管病的危險因素特徵:①糖尿病患者代謝綜閤徵的患病率較高,甚至在低危組也達37.9％,高危組達60.5％;②高危組年齡(65.3 ±11.7)歲高于低危組(50.3±15.4)歲;③高危組收縮壓(143.4±18.1)mmHg高于低危組(125.7±13.2) mmHg;④高危組血壓達標者較少(32.3％);⑤高危組慢性腎病的患病率(21.5％)大大高于中危組(7.7％)和低危組(7.8％).(2)2型糖尿病(高危組31.6％)髮生心血管病的整體風險高于1型糖尿病(高危組16.4％).(3)70～79歲範圍高危組比例高達39.2％.結論 2型糖尿病患者整體髮生心血管病的風險增大,代謝因素可能是增加長期風險的原因,對糖尿病患者的風險評估有利于增加針對性治療的彊度.
목적 탐토성인당뇨병환자가능발생심혈관병적상관위험인소.방법 수집2008년1월지2013년12월재아원주원치료,병력자료완정적년령≥20세적당뇨병환자557례.근거심혈관병위험평고적주요위험인소대매일개체응용불뢰명한풍험평분방법진행평분급분층,＜10％위저위、10％～20％위중위、＞20％위고위.분석미래10년발생심혈관병적상관위험인소.결과 최종납입조사연구 적당뇨병환자공557례,전부위한족,기중남275례,녀282례;1형당뇨병환자79례(14.18％),2형당뇨병환자478례(85.82％).10년총체심혈관병풍험개솔평고발현저위자103례(저위조),점18.5％、중위자91례(중위조),점16.3％、고위자195례(고위조),점35.0％,이전유심혈관병자168례위심혈관병조,점30.2％.(1)불동위험분층발생심혈관병적위험인소특정:①당뇨병환자대사종합정적환병솔교고,심지재저위조야체37.9％,고위조체60.5％;②고위조년령(65.3 ±11.7)세고우저위조(50.3±15.4)세;③고위조수축압(143.4±18.1)mmHg고우저위조(125.7±13.2) mmHg;④고위조혈압체표자교소(32.3％);⑤고위조만성신병적환병솔(21.5％)대대고우중위조(7.7％)화저위조(7.8％).(2)2형당뇨병(고위조31.6％)발생심혈관병적정체풍험고우1형당뇨병(고위조16.4％).(3)70～79세범위고위조비례고체39.2％.결론 2형당뇨병환자정체발생심혈관병적풍험증대,대사인소가능시증가장기풍험적원인,대당뇨병환자적풍험평고유리우증가침대성치료적강도.
Objective To explore the related risk factors between adults with diabetes and cardiovascular disease risk.Methods Five hundred and fifty-seven patients whose age were over 20 years with diabetes mellitus were hospitalized in the First People's Hospital of Shangqiu from Jan.2008 to Dec.2013.According to the major risk factors of cardiovascular risk assessment,Framingham cardiac risk score was use to assess and stratify patients;and then graded as low risk group(＜ 10％),intermediate risk group(10％ to 20％) and the high risk group(＞ 20％).Predicted the next 10 years the probability of the risk of cardiovascular disease.Results Among 557 patients,275 cases were male and 282 cases were female,79 cases (14.18％) were type Ⅰ diabetes mellitus and 478 cases (85.82％) were type Ⅱ diabetes mellitus.Meanwhile,10 years the probability of the risk of cardiovascular disease showed that there were 103 cases of low risk group(18.5％),91 cases of intermediate risk group (16.3％),195 cases of high risk group (30.2％) and 168 cases of cardiovascular disease group who had cardiovascular disease (30.2％).(1) Characteristics of risk factors for cardiovascular disease of risk stratification:①There was high incidence of metabolic syndrome in patients with diabetes mellitus,which was up to 37.9％ even in low risk group and 60.5％ in high risk group.②The average age of high risk group was (63.5 ± 11.7) years old which was higher than the low risk group ((50.3 ± 15.4) years old).③Systolic pressure of high risk group was (143.4 ± 18.1) mmHg,higher than that of the low risk group ((125.7 ± 13.2) mmHg).④It was hard to control the blood pressure in high risk group,so as a few cases(32.3％) were up to the standard.⑤The incidence of chronic kidney disease in high risk group was 21.5％,which was significant higher than that in intermediate risk group(7.7％) and low risk group(7.8％).(2) In high risk groupn,type Ⅱ diabetes mellitus's incidence was 31.6％ which was higher than type Ⅰ diabetes mellitus's(16.4％).(3)In high risk group,the proportion of age range from 70 to 79 years old was up to 39.2％.Conclusion The overall risk of cardiovascular disease increases in patients with type Ⅱ diabetes.Metabolic factors may be the main risk.The risk assessment of diabetic patients will help to increase the intensity of treatment.
