中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2013年
6期
514-518
,共5页
刘秀荣%吴寿岭%王丽晔%苏丽荣%曹正新%周艳茹%孙亚惠%孙月秋%刘丽英
劉秀榮%吳壽嶺%王麗曄%囌麗榮%曹正新%週豔茹%孫亞惠%孫月鞦%劉麗英
류수영%오수령%왕려엽%소려영%조정신%주염여%손아혜%손월추%류려영
脉压%糖尿病%危险性评估
脈壓%糖尿病%危險性評估
맥압%당뇨병%위험성평고
Pulse pressure%Diabetes mellitus%Risk assessment
目的 探讨基线脉压水平对糖尿病人群新发心脑血管事件的影响.方法 本研究以参加2006年7月至2007年10月健康查体的101 510名开滦集团职工中8306例空腹血糖≥7.0mmol/L或＜7.0 mmol/L但正在使用降糖药物且符合入选标准者作为观察队列,随访38 ～53(48.05±3.09)个月,随访期间每半年汇总新发临床终点事件情况.分析脉压水平对糖尿病人群新发心脑血管事件的影响.结果 (1)随着基线脉压水平的增加,总心脑血管事件累积发生率分别为:3.4％、2.8％、4.5％、6.4％；脑梗死为:2.1％、1.6％、2.9％、3.9％；心肌梗死为:1.1％、0.7％、1.0％、1.7％.(2) Cox比例风险回归模型分析结果显示:校正其他危险因素后,脉压分组均为总心脑血管事件、脑梗死和心肌梗死的危险因素,且≥60 mm Hg(1 mm Hg=0.133 kPa)组发生上述事件的风险增加.与基线脉压＜ 40 mm Hg相比,≥60 mm Hg组发生总新脑血管事件、脑梗死事件和心肌梗死事件的RR值分别为1.88(95％ CI 1.34 ～2.65,P＜0.01)、1.92(95％ CI 1.23 ～2.99,P＜0.01)和1.52(95％ CI 0.82 ～2.81,P＞0.05).(3)随着基线脉压水平的增高,糖尿病人群的年龄、男性所占比例、体质量指数、收缩压、舒张压、高密度脂蛋白胆固醇、高敏C反应蛋白的水平也逐渐增高(P＜ 0.01或P＜0.05).结论 基线高脉压水平是影响糖尿病人群新发心脑血管事件的危险因素.
目的 探討基線脈壓水平對糖尿病人群新髮心腦血管事件的影響.方法 本研究以參加2006年7月至2007年10月健康查體的101 510名開灤集糰職工中8306例空腹血糖≥7.0mmol/L或＜7.0 mmol/L但正在使用降糖藥物且符閤入選標準者作為觀察隊列,隨訪38 ～53(48.05±3.09)箇月,隨訪期間每半年彙總新髮臨床終點事件情況.分析脈壓水平對糖尿病人群新髮心腦血管事件的影響.結果 (1)隨著基線脈壓水平的增加,總心腦血管事件纍積髮生率分彆為:3.4％、2.8％、4.5％、6.4％；腦梗死為:2.1％、1.6％、2.9％、3.9％；心肌梗死為:1.1％、0.7％、1.0％、1.7％.(2) Cox比例風險迴歸模型分析結果顯示:校正其他危險因素後,脈壓分組均為總心腦血管事件、腦梗死和心肌梗死的危險因素,且≥60 mm Hg(1 mm Hg=0.133 kPa)組髮生上述事件的風險增加.與基線脈壓＜ 40 mm Hg相比,≥60 mm Hg組髮生總新腦血管事件、腦梗死事件和心肌梗死事件的RR值分彆為1.88(95％ CI 1.34 ～2.65,P＜0.01)、1.92(95％ CI 1.23 ～2.99,P＜0.01)和1.52(95％ CI 0.82 ～2.81,P＞0.05).(3)隨著基線脈壓水平的增高,糖尿病人群的年齡、男性所佔比例、體質量指數、收縮壓、舒張壓、高密度脂蛋白膽固醇、高敏C反應蛋白的水平也逐漸增高(P＜ 0.01或P＜0.05).結論 基線高脈壓水平是影響糖尿病人群新髮心腦血管事件的危險因素.
목적 탐토기선맥압수평대당뇨병인군신발심뇌혈관사건적영향.방법 본연구이삼가2006년7월지2007년10월건강사체적101 510명개란집단직공중8306례공복혈당≥7.0mmol/L혹＜7.0 mmol/L단정재사용강당약물차부합입선표준자작위관찰대렬,수방38 ～53(48.05±3.09)개월,수방기간매반년회총신발림상종점사건정황.분석맥압수평대당뇨병인군신발심뇌혈관사건적영향.결과 (1)수착기선맥압수평적증가,총심뇌혈관사건루적발생솔분별위:3.4％、2.8％、4.5％、6.4％；뇌경사위:2.1％、1.6％、2.9％、3.9％；심기경사위:1.1％、0.7％、1.0％、1.7％.(2) Cox비례풍험회귀모형분석결과현시:교정기타위험인소후,맥압분조균위총심뇌혈관사건、뇌경사화심기경사적위험인소,차≥60 mm Hg(1 mm Hg=0.133 kPa)조발생상술사건적풍험증가.여기선맥압＜ 40 mm Hg상비,≥60 mm Hg조발생총신뇌혈관사건、뇌경사사건화심기경사사건적RR치분별위1.88(95％ CI 1.34 ～2.65,P＜0.01)、1.92(95％ CI 1.23 ～2.99,P＜0.01)화1.52(95％ CI 0.82 ～2.81,P＞0.05).(3)수착기선맥압수평적증고,당뇨병인군적년령、남성소점비례、체질량지수、수축압、서장압、고밀도지단백담고순、고민C반응단백적수평야축점증고(P＜ 0.01혹P＜0.05).결론 기선고맥압수평시영향당뇨병인군신발심뇌혈관사건적위험인소.
Objective To observe the association between baseline pulse pressure (PP)level and new-onset cardio-cerebrovascular events in diabetic population.Methods Physical examination data between July 2006 to October 2007 from a total of 101 510 employees of Kailuan Group were reviewed,8306 subjects with a fasting plasma glucose level of ≥ 7.0 mmol/L or with confirmed diabetes diagnosis and were enrolled in this prospective cohort study.Subjects were followed up for 38-53 (48.1 ± 3.1) months and the cardio-cerebrovascular events were obtained every six months,association between baseline PP and new-onset cardio-cerebrovascular events in the diabetic population were analyzed.Results (1) Incidences of total cardio-cerebrovascular events in the PP groups were 3.4％,2.8％,4.5％,6.4％,respectively.Incidences of cerebral infarction events and myocardial infarction were 2.1％,1.6％,2.9％,3.9％ and 1.1％,0.7％,1.0％,1.7％,respectively.(2) Multivariate Cox' s proportional hazards regression analysis indicated that baseline PP group was the risk factor for total cardio-cerebrovascular events,cerebral infarction events and myocardial infarction,and the risk for all the events of the PP≥60 mm Hg (1 mm Hg =0.133 kPa) group was increasing.The values of RR(95％ CI) were 1.88 (95％ CI 1.34-2.65,P ＜ 0.01),1.92 (95 ％ CI 1.23-2.99,P ＜ 0.01) and 1.52 (95 ％ CI 0.82-2.81,P ＞ 0.05) after adjust the other factors.(3) In line with increasing level of baseline PP,age,BMI,SBP,DBP,HDL-C,and hs-CRP levels significantly increased in this diabetic population (P ＜ 0.01 or P ＜ 0.05).Conclusion The level of high baseline PP is a risk factor for new-onset cardio-cerebrovascular events in diabetic population.
