目的 探讨晚期心力衰竭(heartfailure，HF)合并2型糖尿病(diabetes mellitus type 2，T2DM)的临床特征和短期预后。方法 应用前瞻性队列研究方法，选取2020年7月-2022年6月在新乡市第四人民医院住院治疗的晚期HF患者248例，根据是否患有T2DM将其分为无T2DM组(n=133)和T2DM组(n=115)。对比分析两组患者的一般资料和临床预后。结果 248例HF患者中，合并T2DM115例，未合并T2DM133例。T2DM组较之于无T2DM组，年龄较小，合并慢性肾病的比例较大，有心肌梗死史的较多，HF病程比较长，肌酐、肌钙蛋白T及NT-proBNP水平较高，差异有统计学意义(P＜0。05)，T2DM组收缩压和舒张压稍高于无T2DM组(P＞0。05)。与未合并DM的晚期HF患者相比较，合并DM患者的晚期HF患者具有更高的6个月全因再入院率(P＜0。05)。以不发生全因死亡或全因再入院为良好结局终点，无T2DM组的良好结局率(42。10％)高于T2DM组(14。78％)(P＜0。05)。多因素分析结果:年龄大、合并症数目多、收缩压高是晚期HF患者6个月全因死亡的危险因素。LVEF是晚期HF患者6个月全因死亡的保护因素(P＜0。05)。结论 T2DM会恶化晚期HF患者的临床预后，但不会增加患者的短期死亡率。
Clinical study on clinical features and short-term prognosis of advanced heart failure complicated with type 2 diabetes mellitus
Objective To compare the clinical characteristics and short-term prognosis of late stage HF patients with and without T2DM.Methods A prospective cohort study A total of 248 patients with advanced HF hospitalized in the Fourth People's Hospital of Xinxiang City from July 2020 to June 2022 were selected.According to whether they had T2DM,they were divided into two groups:no T2DM group(n=133)and T2DM group(n=115).Compare and ana-lyze the general information and clinical prognosis of two groups of patients,and evaluate the effectiveness of prognostic prediction models.Results Among 248 HF patients,115 had T2DM and 133 did not.Compared with the non-T2DM group,T2DM group had younger age,higher proportion of chronic kidney disease,more history of myocardial infarction,longer HF course,and higher levels of creatinine,troponin T and NT-proBNP,with statistical significance(P＜0.05);systolic and diastolic blood pressure in T2DM group were slightly higher than those in the non-T2DM group(P＞0.05).Compared with late stage HF patients without DM,late stage HF patients with DM have a higher 6-month all-cause readmission rate(P＜0.05).The good outcome rate in the non T2DM group(42.10％)was signifi-cantly higher than that in the T2DM group(14.78％),with no all-cause death or all-cause readmission as the good end point(P＜0.05).Multivariate analysis results:Older age,more comorbidities,and higher systolic blood pressure were risk factors for all cause death at 6 months in advanced HF patients.LVEF is a protective factor for all cause death at 6 months in patients with advanced HF(P＜0.05).Conclusion T2 DM can worsen the clinical prognosis of patients with advanced HF,but it will not increase the short-term mortality rate of patients.
Type 2 diabetesheart failureLater periodfeaturesprognosisshort-term
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