CAJ | 학술논문

目的筛选糖尿病患者发生围术期心血管事件(PCE)的危险因素.方法择期行非心脏手术的糖尿病患者500例,根据围术期是否发生PCE分为PCE组和非PCE组.记录患者一般资料和麻醉方式、麻醉时间、术中血糖、血流动力学波动情况.将组间差异有统计学意义的因素进行logis-tic回归分析,筛选PCE的危险因素.结果 79例患者发生PCE,发生率为15.8％.2组患者年龄、甘油三酯水平、高敏C反应蛋白(hs-CRP)水平、血流动力学波动情况、ECG异常比率比较差异有统计学意义(P＜0.05).logistic回归分析结果显示,甘油三酯≥1.7 mmol/L、年龄≥65岁、hs-CRP≥8mg/L和术中血流动力学异常波动≥基础值30％是非心脏手术糖尿病患者PCE的危险因素.结论高甘油三酯、老龄、高hs-CRP水平和术中血流动力学异常波动(≥基础值30％)是糖尿病患者非心脏手术围术期PCE的危险因素.
목적 사선당뇨병환자발생위술기심혈관사건(PCE)적위험인소.방법 택기행비심장수술적당뇨병환자500례,근거위술기시부발생PCE분위PCE조화비PCE조.기록환자일반자료화마취방식、마취시간、술중혈당、혈류동역학파동정황.장조간차이유통계학의의적인소진행logis-tic회귀분석,사선PCE적위험인소.결과 79례환자발생PCE,발생솔위15.8％.2조환자년령、감유삼지수평、고민C반응단백(hs-CRP)수평、혈류동역학파동정황、ECG이상비솔비교차이유통계학의의(P＜0.05).logistic회귀분석결과현시,감유삼지≥1.7 mmol/L、년령≥65세、hs-CRP≥8mg/L화술중혈류동역학이상파동≥기출치30％시비심장수술당뇨병환자PCE적위험인소.결론 고감유삼지、노령、고hs-CRP수평화술중혈류동역학이상파동(≥기출치30％)시당뇨병환자비심장수술위술기PCE적위험인소.
Objective To determine the risk factors for perioperative cardiovascular events (PCEs) in patients with diabetes mellitus undergoing noncardiac surgery.Methods From June 2011 to October 2012 in our hospital,500 diabetic patients scheduled for elective non-cardiac surgery were divided into 2 groups according to the development of PCEs:PCE group and non-PCE group.The general data of patients,anesthetic methods,anesthesia time,blood glucose level during surgery and fluctuation of hemodynamics were recorded.The risk factors of which P values were less than 0.05 would enter the binary logistic regression analysis to stratify PCE-related risk factors.Results Seventy-nine patients developed PCEs (15.8 ％) during perioperative period.There was significant difference between the two groups in age,levels of triglyceride and hs-CRP,fluctuation of hemodynamics,and abnormality in ECG (P ＜ 0.05).Logistic regression analysis showed that the risk factors for PCEs included triglyceride level ≥ 1.7 mmol/L,age ≥ 65yr,hs-CRP level ≥ 8 mg/L and fluctuation of hemodynamics during surgery ≥ 30％ of the baseline value.Conclusion High triglyceride levels,advanced age,high hs-CRP levels and fluctuation of hemodynamics during surgery (≥ 30％ of the baseline value) are the risk factors for PCE in diabetic patients undergoing noncardiac surgery.