CAJ | 학술논문

目的：探讨2型糖尿病（DM）合并冠心病（CHD）的老年患者在急诊科观察的临床特点。方法：回顾性分析2011年12月至2012年12月在广州市第一人民医院急诊科观察的880例2型DM老年患者的临床资料。根据是否合并CHD将患者分为CHD组（共318例）和无CHD组（共562例），观察比较两组患者的临床资料，通过logistic回归分析2型DM老年患者CHD的独立相关因素。结果：与无CHD组比较，CHD组年龄较高（79±7 vs73±8岁P＜0．05），DM病程较长（16±7 vs 12±7年，P＜0．05），糖化血红蛋白（HbA1c）水平较高（7．8±1．5％vs 6．8±1．2％，P＜0．05），收缩压（SBP）较高（160±17 vs138±15mmHg，P＜0．05），CHD阳性家族史和DM阳性家族史的发生率较高（P值都＜0．05）；Logistic多元回归分析表明年龄、DM病程、SBP、低密度脂蛋白胆固醇（LDL－C）水平、HbA1c水平、CHD家族史和合并脑卒中是2型DM老年患者发生CHD的独立相关因素。结论：在急诊科观察的2型DM老年患者合并CHD时表现出多种危险因素并存，临床上要控制血糖、血压和血脂，重视对病程长、有CHD家族史、合并脑卒中的DM患者的管理。
목적：탐토2형당뇨병（DM）합병관심병（CHD）적노년환자재급진과관찰적림상특점。방법：회고성분석2011년12월지2012년12월재엄주시제일인민의원급진과관찰적880례2형DM노년환자적림상자료。근거시부합병CHD장환자분위CHD조（공318례）화무CHD조（공562례），관찰비교량조환자적림상자료，통과logistic회귀분석2형DM노년환자CHD적독립상관인소。결과：여무CHD조비교，CHD조년령교고（79±7 vs73±8세P＜0．05），DM병정교장（16±7 vs 12±7년，P＜0．05），당화혈홍단백（HbA1c）수평교고（7．8±1．5％vs 6．8±1．2％，P＜0．05），수축압（SBP）교고（160±17 vs138±15mmHg，P＜0．05），CHD양성가족사화DM양성가족사적발생솔교고（P치도＜0．05）；Logistic다원회귀분석표명년령、DM병정、SBP、저밀도지단백담고순（LDL－C）수평、HbA1c수평、CHD가족사화합병뇌졸중시2형DM노년환자발생CHD적독립상관인소。결론：재급진과관찰적2형DM노년환자합병CHD시표현출다충위험인소병존，림상상요공제혈당、혈압화혈지，중시대병정장、유CHD가족사、합병뇌졸중적DM환자적관리。
Objective:To investigate the clinical features of the elderly patients with type 2 diabetes mellitus (DM) combined with coronary heart disease (CHD) who were kept in emergency department for observation. Methods: The clinical materials of 880 elderly patients with type 2 DM that were kept for observation in emergency department in Guangzhou First People's Hospital from December 2011 to December 2012 were retrospectively analyzed. According to whether with or without CHD, the patients were divided into CHD group (318) and non-CHD group (562). The clinical materials of two groups were observed and compared, and the independent correlation factors of CHD in elderly patients with type 2 DM were analyzed by logistic regression analysis. Results:Compared with the patients in non-CHD group, the patients in CHD group were older (79±7 vs 73±8y, P<0.05), and had a longer course of DM (16±7 vs 12±7y,P<0.05), and had a higher level of glycosylated hemoglobin A1c (HbA1c) (7.8±1.5%vs 6.8±1.2%,P<0.05), and had a higher systolic blood pressure (SBP) (160±17 va 138±15mmHg,P<0.05), and had a higher rate of CHD and DM family histories. According to the logistic regression, the independent correlation factors of CHD in elderly type 2 DM patients were age, the course of DM, SBP, low density lipoprotein cholesterol (LDL-C), the level of HbA1c, the family history of CHD, and the history of stroke. Conclusions:There were coexistent multiple risk factors in the elderly patients with type 2 DM combined with CHD that were kept for observation in emergency department. Blood glucose, blood pressure and blood lipid should be controlled clinically, and the management of patients with DM who had a long course, a family history of CHD and a history of stroke should be attached importance to.