中华内分泌代谢杂志
中華內分泌代謝雜誌
중화내분비대사잡지
CHINESE JOURNAL OF ENDOCRINOLOGY AND METABOLISM
2014年
1期
22-25
,共4页
血液透析%心血管事件%空腹血糖%炎症
血液透析%心血管事件%空腹血糖%炎癥
혈액투석%심혈관사건%공복혈당%염증
Hemodialysis%Cardiovascular events%Fasting plasma glucose%Inflammation
目的 探讨维持性血液透析的糖尿病患者空腹血糖控制情况与心血管事件发生风险的关系.方法 根据空腹血糖,将2009年7月在本科进行规律血液透析的154例患者分为3组:非糖尿病空腹血糖正常组(A组,n=84)、糖尿病空腹血糖控制良好组(B组,n=41)、糖尿病空腹血糖控制欠佳组(C组,n=29),收集患者人体测量学指标、实验室数据,并随访36个月,记录患者心血管事件及低血糖发生情况.结果 B组和C组患者超敏C反应蛋白(CRP)及甘油三酯较A组患者高,腰围较A组大;C组患者高密度脂蛋白胆固醇及全段甲状旁腺激素水平最低,而体重指数最高(P＜0.05).随访期间共发生47例心血管事件,用Kaplan-Meier法分析心血管事件累计发生率,C组明显高于A组和B组(均P＜0.01),而后2组间差异无统计学意义.经多因素Cox风险回归分析表明空腹血糖≥7.2 mmol/L、超敏CRP是心血管事件累计发生的独立危险因素(P＜0.05或P＜0.01).结论 空腹血糖控制在5.6 ～7.2 mmol/L可显著改善合并糖尿病的维持性血液透析患者心血管预后.
目的 探討維持性血液透析的糖尿病患者空腹血糖控製情況與心血管事件髮生風險的關繫.方法 根據空腹血糖,將2009年7月在本科進行規律血液透析的154例患者分為3組:非糖尿病空腹血糖正常組(A組,n=84)、糖尿病空腹血糖控製良好組(B組,n=41)、糖尿病空腹血糖控製欠佳組(C組,n=29),收集患者人體測量學指標、實驗室數據,併隨訪36箇月,記錄患者心血管事件及低血糖髮生情況.結果 B組和C組患者超敏C反應蛋白(CRP)及甘油三酯較A組患者高,腰圍較A組大;C組患者高密度脂蛋白膽固醇及全段甲狀徬腺激素水平最低,而體重指數最高(P＜0.05).隨訪期間共髮生47例心血管事件,用Kaplan-Meier法分析心血管事件纍計髮生率,C組明顯高于A組和B組(均P＜0.01),而後2組間差異無統計學意義.經多因素Cox風險迴歸分析錶明空腹血糖≥7.2 mmol/L、超敏CRP是心血管事件纍計髮生的獨立危險因素(P＜0.05或P＜0.01).結論 空腹血糖控製在5.6 ～7.2 mmol/L可顯著改善閤併糖尿病的維持性血液透析患者心血管預後.
목적 탐토유지성혈액투석적당뇨병환자공복혈당공제정황여심혈관사건발생풍험적관계.방법 근거공복혈당,장2009년7월재본과진행규률혈액투석적154례환자분위3조:비당뇨병공복혈당정상조(A조,n=84)、당뇨병공복혈당공제량호조(B조,n=41)、당뇨병공복혈당공제흠가조(C조,n=29),수집환자인체측량학지표、실험실수거,병수방36개월,기록환자심혈관사건급저혈당발생정황.결과 B조화C조환자초민C반응단백(CRP)급감유삼지교A조환자고,요위교A조대;C조환자고밀도지단백담고순급전단갑상방선격소수평최저,이체중지수최고(P＜0.05).수방기간공발생47례심혈관사건,용Kaplan-Meier법분석심혈관사건루계발생솔,C조명현고우A조화B조(균P＜0.01),이후2조간차이무통계학의의.경다인소Cox풍험회귀분석표명공복혈당≥7.2 mmol/L、초민CRP시심혈관사건루계발생적독립위험인소(P＜0.05혹P＜0.01).결론 공복혈당공제재5.6 ～7.2 mmol/L가현저개선합병당뇨병적유지성혈액투석환자심혈관예후.
Objective To investigate the potential contributing effects of fasting plasma glucose on cardiovascular events in diabetic patients treated with maintenance hemodialysis.Methods According to fasting plasma glucose,154 patients undergoing maintenance hemodialvsis in our department were assigned into group A (n =84) nondiabetic with normal fasting blood glucose,group B (n =41) diabetic with good control of fasting blood glucose,and group C (n =29) diabetic with poor control of fasting glucose.Anthropometric and laboratory data were collected,and the participants were followed up for 36 months.Cardiovascular events and hypoglycemia were recorded and analyzed.Results Highly-sensitive C reactive protein (hs-CRP),triglyceride,and waist circumference were significantly higher in group B and group C compared with group A.Bodv mass index in group C was the highest while high density lipoprotein-cholesterol and intact parathyroid hormone levels were the lowest among 3 groups (P＜0.05).During the 36 months follow-up,47 cases of cardiovascular events occurred.Kaplan-Meier curves showed that cumulative incidence of cardiovascular events was significantly higher in group C than group A and B (both P＜0.01),and no significant difference was found between group A and B.Cox regressive analysis revealed that fasting plasma glucose and hs-CRP were independant risk factors for cumulative incidence of cardiovascular events (P＜0.05 or P＜0.0l).Conclusions If fasting plasma glucose is contmlled within the range of 5.6 to 7.2 mmol/L,cardiovascular outcomes may be significantly ameliorated in diabetic patients treated with maintenance hemodialysis.
