2 型糖尿病多因素干预与心肌缺血相关性分析.docVIP

2型糖尿病多因素干预与心肌缺血相关性分析 赵婕1，张忠辉1，黄定德2，李前伟2，陈兵1（400038 重庆，第三军医大学：1西南医院内分泌科， 2西南医院核医学科） [摘要] 目的 观察新诊断2型糖尿病患者多因素干预和心肌缺血的关系，尝试为建立糖尿病大血管病变预警系统奠定基础。方法 新诊断2型糖尿病患者经血糖、血脂、血压强化干预8年后，采用腺苷负荷下心肌核素显像MPI阳性率之间的关系。结果 本组患者心肌缺血阳性率为25%，Logistic分析示有胸闷史(OR=49.963,95%CI=9.525～262.067,P=0.000)高血压超过130/85mmHg(OR=4.684,95% CI=1.064～20.239,P=0.032)总胆固醇超过4.66m-mol/l(OR=7.297,95%CI=1.247～42.691,P=0.027)(OR=4.640，95%CI=1.064～20.239,P=0.041)4项Relationship between effect of multiple risk factors intervention and myocardial ischemia in type 2 diabetes ZHAO Jie1，ZHANG Zhong-hui1，HUANG Ding-de2，LI Qian-wei2,CHEN Bing1（1 Department of Endocrinology,Southwest Hospital, Chongqing 400038,China， 2 Department of nuclear, Southwest Hospital, Chongqing 400038,China） [Abstract] Objective To observe the relationship between the effect of multi-factor intervention and myocardial ischemia in newly diagnosed type 2 diabetes, and to screen out the (early) risk factors for diabetic myocardial ischemia.Methods Patients with newly diagnosed type 2 diabetes(duration≤1 year) were recepted controls of hyperglycaemia, hyperlipemia and hypertension. After 8 years clinical follow-up,all were assessed by adenosine stress myocardial perfusion imaging(MPI) in order to compare with the control rate and the positive result of MPI.Results Logistic analysis indicated that the history of chest distress (OR =49.963,95%CI=9.525～262.067,P=0.000), the poor controls of blood pressure (OR= 4.684,95%CI= 1.064～20.239,P=0.032), the total cholesterol (OR=7.297, 95%CI=1. 247～42.691,P=0.027) and mean glycosylated hemoglobin(OR=4.640，95%CI=1. 064～20.239,P=0.041) were correlated with the incidence of diabetes related cornoary artery diease.Conclusion Poor control of intervention is a high risk factor of myocardial ischemia in type 2 diabetes.The more strictly and more effectively control overall cardical risk factors will reduce the development of myocardial ischemia. [Key words] type 2 diabetes,intensive control,myocardial ischemia,radio n