青岛大学学报(医学版)2024，Vol.60Issue(5) ：714-718.DOI:10.11712/jms.2096-5532.2024.60.151

2型糖尿病对冠心病伴HFpEF预后影响及因素分析

Influence of type 2 diabetes mellitus on the prognosis of patients with coronary heart disease and heart failure with preserved ejection fraction and related factors

张娟 张艺 张根生 赵晓宏
青岛大学学报(医学版)2024，Vol.60Issue(5) ：714-718.DOI:10.11712/jms.2096-5532.2024.60.151
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  • 维普
  • 万方数据

2型糖尿病对冠心病伴HFpEF预后影响及因素分析

Influence of type 2 diabetes mellitus on the prognosis of patients with coronary heart disease and heart failure with preserved ejection fraction and related factors

张娟 1张艺 2张根生 3赵晓宏1
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作者信息

  • 1. 中国人民解放军第3201医院内分泌科,陕西汉中 723000
  • 2. 西安市第九医院全科医学科
  • 3. 中国人民解放军第3201医院骨科
  • 折叠

摘要

目的 探讨2型糖尿病(T2DM)对冠心病伴射血分数保留心力衰竭(HFpEF)病人预后影响.方法 采用病例对照研究方法,选取2021年8月-2023年1月在中国人民解放军第3201医院治疗的合并T2DM的冠心病伴HFpEF病人65例为观察组,同时以年龄、性别配比1∶2选取未合并T2DM的冠心病伴HFpEF病人130例为对照组,比较两组临床基线资料、实验室检查、超声心动图检查以及主要心血管不良事件(MACE)发生率等指标,分析影响MACE发生的危险因素.结果 观察组血清甘油三酯(TG)、左室后壁厚度(LVPWD)和MACE发生率等均明显高于对照组(t=4.227、5.508,x2=10.543,P＜0.05).已发生MACE病人年龄、血清TG和N端脑钠肽的前体(NT-proBNP)含量及并发糖尿病构成比等均明显高于未发生者(t=4.855、5.590,Z=-3.432,x2=10.543,P＜0.05).Logistic 回归分析显示,年龄(OR=2.748,95％CI=1.671～4.521)、NT-proBNP(OR=3.755,95％CI=2.025～6.962)和糖尿病(OR=2.428,95％CI=1.565～3.766)等变量是影响冠心病伴HFpEF病人发生MACE的危险因素(P＜0.05).结论 T2DM并发冠心病伴HFpEF病人MACE发生率显著升高,T2DM是影响冠心病伴HFpEF病人不良预后的风险因素,临床应早期干预以降低MACE的发生.

Abstract

Objective To investigate the influence of type 2 diabetes mellitus(T2DM)on the prognosis of patients with co-ronary heart disease(CHD)and heart failure with preserved ejection fraction(HFpEF).Methods A case-control study was conducted.A total of 65 CHD patients with T2DM and HFpEF who were treated in The 3201 Hospital of the Chinese People's Li-beration Army from August 2021 to January 2023 were enrolled as observation group,and 130 patients with CHD and HFpEF,matched for age and sex at a ratio of 1∶2,who did not have T2DM were enrolled as control group.The two groups were compared in terms of clinical baseline data,laboratory tests,echocardiography,and the incidence rate of major adverse cardiovascular events(MACE),and the influencing factors for MACE were analyzed.Results Compared with the control group,the observation group had significantly higher serum triglyceride(TG),left ventricular posterior wall thickness,and incidence rate of MACE(t=4.227,5.508;x2=10.543;P＜0.05).Compared with the patients without MACE,the patients with MACE had significantly higher age,serum level of TG and N-terminal pro brain natriuretic peptide(NT-proBNP),and constituent ratio of patients comorbid with diabetes(t=4.855,5.590;Z=-3.432;x2=10.543;P＜0.05).The Logistic regression analysis showed that age(OR=2.748,95％CI=1.671-4.521,P＜0.05),NT-proBNP(OR=3.755,95％CI=2.025-6.962,P＜0.05),and diabetes(OR=2.428,95％CI=1.565-3.766,P＜0.05)were risk factors for MACE in patients with CHD and HFpEF.Conclusion There is a significant in-crease in the incidence rate of MACE in patients with T2DM comorbid with CHD and HFpEF.T2DM is a risk factor for the poor prognosis of patients with CHD and HFpEF,and early clinical interventions should be performed to reduce the incidence rate of MACE.

关键词

冠心病/糖尿病,2型/心力衰竭/心排血量/预后/影响因素分析

Key words

coronary disease/diabetes mellitus,type 2/heart failure/cardiac output/prognosis/root cause analysis

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出版年

2024
青岛大学学报(医学版)
青岛大学医学院

青岛大学学报(医学版)

CSTPCD
影响因子：0.8
ISSN：1672-4488
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