他汀强化治疗的2型糖尿病患者并发冠心病的危险因素分析-论文.pdf

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1、昆明医科大学学报2014，35(9)：56—60CN53—1221／RJournalofKunmingMedicalUniversity他汀强化治疗的2型糖尿病患者并发冠心病的危险因素分析李虹道”，舒占坤”，钱炳坤”，刘基建”，赵玲∞，喻卓2)，蒲里津∞(1)罗平县人民医院，云南罗平655800；2)昆明医科大学第一附属医院心内科，云南昆明650032)[摘要]目的探讨他汀治疗的糖尿病患者发生冠心病(CAD)的残余风险．方法入选进行冠脉造影及介入治疗并在人院前已强化他汀调脂治疗且LDL—C达标(<2．6mmo1]t)的2型糖尿病

2、(T2DM)患者290例，按冠脉造影结果分为糖尿病并冠心病组200例，进一步按冠脉病变支数分为3个血管病变亚组，无冠脉病变者90例为对照组，Logistic回归分析发生CAD的残余风险．结果Logistic回归分析显示HbAlc／HDL比值是强化他汀治疗后的T2DM患者发生CAD的独立预测因子(OR=I．45，95％CI1．129—1．863，P=0．OO4)．3一支冠脉病变组HbAlc／HDL比值(8．71±2．46)明显高于2一支病变组(7．26±1．54)及1一支病变组(6．80±2．00)．HbAlc／HDL比值与冠脉病

3、变广泛程度指数(Pearson’sr=O．516，P<0．01)及冠脉病变支数(Spearman’sr=O．442，P=0．032)正相关．结论HbAlc／HDL比值是他汀强化调脂治疗的2型糖尿病患者发生CAD的独立预测因子，并与CAD的严重程度相关．[关键词]糖尿病；冠心病；他汀；高密度脂蛋白[中图分类号]R587．2[文献标识码]A[文章编号]2095-610X(2014)09—0056—05AnalysisofRiskFactorsforCoronaryArteryDiseaseinType2DiabeticPatient

4、sReceivedAggressiveLipid-modifyingTherapyLIH0ng—dao”，SHUZhan-kun”，QIANBing-kun”，LIUJi—jian”，ZHAOling，YuZhuo，PULi—jin’(1)People’sHospitalofLuoping，LuoplugYunnan655800；2)Dept．ofCardiology，The1stAffiliatedHospitalofKunmingMedicalUniversity，KunmingYunnan650032，China)[Abs

5、tract]ObjectiveToinvestigatetheresidualriskofCADoceurenceintype2diabeticpatientsreceivedaggressivelipid-modifyingtherapy．Methods290diabeticpatientswhoreceivedaggressivelipid-modifyingtherapy(LDL<2．6mmol／L)andcoronaryangiographyorpercutaneouscoronaryinterventionweredi

6、videdintotwogroups．Theexperimentgroupconsistedof200CADpatientswithT2DMandwassubdividedintothreediseasedcoronaryarteriessubgroups．90diabeticpatientswithoutCADwereservedascontro1．MultivariatelogisticregressionmodelwasusedtoanalyzetheresidualriskforCAD．ResultsMultivaria

7、telogisticregressionmodelidentifiedHbAlc／HDLratioasaindependentriskfactorforCADintype2diabeticpatientswhoreceivedaggressivelipid-modifyingtherapy(OR=1．45，95％CI1．129-1．863，P=O．004)．HbAlc／HDLratioweresignificantlyhigherinpatientswith3-vesseldisease(8．71±2．46)comparedwi

8、ththoseinwith2-vessel(7．26±1．54)and1-vesseldiseasegroups(6．80±2．00，P<0．05)，respectively．TherewerepositivecorrelationsofHbAlc／HDLrat