低血糖和糖尿病足.ppt

本文观看结束！！！ * 在FISMAN EZ等人的随访研究之前，对冠心病患者低血糖与全因死亡率的关系并没有明确的定论。而这项以色列大型8年随访调查结果的出炉，提示我们低血糖是全因死亡率的危险因素之一。 研究目的背景：试图阐明冠心病患者低血糖与全因死亡率，心血管，癌症死亡率的关系。 方法：共纳入14670名患者，年龄跨度在45-75岁，并分为6各组。 低血糖（上限血糖69 mg/dl），131人 正常血糖低限（70-79 mg/dl），731人 正常血糖（80-109 mg/dl），9308人 IFG（110-125 mg/dl），1577人 糖尿病临界（126-139 mg/dl），617人 糖尿病：随访8年后，在糖尿病组及低血糖组的全因死亡率叫正常血糖组显著升高（p0.001），CAD死亡率在糖尿病及临界组较正常组明显升高。另外生存分析表明正常血糖和正常低限组的死亡率最低。 图示为校正后的低血糖组全因死亡率、冠心病死亡率、脑血管意外死亡率、肿瘤死亡率与正常血糖的的比较，可见低血糖组的全因死亡率显著高于正常血糖组。 结论：低血糖是CAD患者全因死亡率的预示因子（HR=1.84 95%CI(1.29-2.61)） 下面是原摘要 Is hypoglycaemia a marker for increased long-term mortality risk in patients with coronary artery disease? An 8-year follow-up. Fisman EZ, Motro M, Tenenbaum A, Leor J, Boyko V, Mandelzweig L, Sherer Y, Adler Y, Behar S. Cardiac Rehabilitation Institute, Chaim Medical Center, Tel-Hashomer, and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel. zfisman@post.tau.ac.il BACKGROUND: No information is available regarding the association between low plasma glucose levels and cause-specific and all-cause mortality in patients with coronary artery disease (CAD). We aimed to investigate the relationship between hypoglycaemia and all-cause, cardiovascular and cancer mortality in a large population of patients with CAD. DESIGN: Patients were recruited from the BIP (Bezafibrate Infarction Prevention) registry, a secondary prevention prospective multicentre randomized, placebo-controlled, double-blind trial aimed to assess the efficacy of bezafibrate in reduction of coronary events. METHODS: The study included 14,670 CAD patients aged 45-74, divided into six groups: (1) hypoglycaemic (up to 69 mg/dl); (2) low normal (70-79 mg/dl); (3) euglycaemic (80-109 mg/dl); (4) impaired fasting glucose (IFG) (110-125 mg/dl); (5) borderline diabetics (126-139 mg/dl); (6) diabetics ( or 140 mg/dl). RESULTS: Patients comprised 131 with hypoglycaemia (0.9%), 731 with low normal glucose (5%), 9308 euglycaemic (63.4%), 1577 with IFG (10.7%), 617 borderline diabetics (4.