| 昊云涛,刘亚男,吴寿岭,李云,邢爱君,金成,施继红,杜鑫.不同危险分层对糖尿病患者临床终点事件的影响[J].Chinese journal of Epidemiology,2012,33(1):88-91 |
| 不同危险分层对糖尿病患者临床终点事件的影响 |
| Study on the effects of different risk stratifications in patients with diabetes mellitus：a clinicalendpoint event |
| Received:July 20, 2011 |
| DOI： |
| KeyWord: 糖尿病 心脑血管事件 危险因素 |
| English Key Word: Diabetes mellitus Cardiovascular and cerebrovascular events Risk factors |
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| Abstract: |
| 目的 探讨不同危险分层对糖尿病患者临床终点事件的影响。方法 采用前瞻性队列研究方法，以参加2006年7月至2007年10月健康查体的101510名开滦煤矿集团职工中空腹血糖≥7.0 mmol/L或＜7.0 mmol/L已确诊为糖尿病正在使用降糖药物的8302例患者作为观察队列，采用中国医学科学院心血管病研究所开发的“国人缺血性心血管病10年发病危险的评估方法”，将研究队列依据发病风险分为极低危、低危、中危和高危组，随访38～53(48.01±3.14)个月，随访期间每半年收集一次新发心脑血管事件情况。分析不同危险分层对糖尿病人群新发心脑血管事件的影响。结果 (1)随着发病风险的增加，发生总心脑血管事件、心肌梗死、脑卒中、心血管死亡以及全因死亡事件率均逐渐增高，差异有统计学意义(P＜0.01)；而发生猝死事件率的差异无统计学意义(P＞0.05)。(2)校正年龄及性别因素，Cox比例风险回归分析表明，随着发病风险的增加，相对于极低危组，中危和高危组发生总心脑血管事件的相对危险(RR)分别增加1.42倍(95％CI:1.02～ 1.96,P＜0.05)、2.26倍(95％CI:1.67～3.04,P＜0.01)。结论 在作为高危人群的糖尿病患者中,缺血性心血管病主要危险因素年龄增加、高血压、BMI、总胆固醇水平、吸烟可预测该人群发生心脑血管事件，随着发病因素增加,临床发生心脑血管事件的危险亦增加。 |
| English Abstract: |
| Objective To estimate the relationship between the risk stratification of patients with diabetes and their clinical endpoint events.Methods In this cohort study,we prospectively followed 8302 individuals under the following situations: contents of fasting plasma glucose ≥7.0 mmol/L,being diagnosed as diabetes or having used hypoglycemic drugs from Kailuan study in which 101510 employees (81110 males,20400 females,who were being employed and those retired from the company were included) from the Kailuan Company,were screened.During the 38-53(48.01 ± 3.14) months of follow-up period,a new heart or cerebrovascular events were ascertained every six months.The impacts of different risk stratification in diabetic population on the incidence rates of cardiovascular and cerebrovascular events were estimated.Results Using the definitions of “people with ischemic cardiovascular disease incidence of 10-year risk assessment methods”developed by the Chinese Academy of Medical Sciences,Institute of Cardiovascular Disease,the study cohort was divided into four groups,namely,very low-risk,low risk,medium risk and high risk.(1) Along with the increasing risk of the disease,the incidence rates of total cardiovascular and cerebrovascular events,myocardial infarction,stroke,cardiovascular death and all-cause death rate also gradually increased and the differences were statistically significant (P＜0.01).However,the difference on incidence rate of sudden death was not significantly different (P＞0.05).(2)Compared to the very low-risk group,the age and sex adjusted relative risk for cardiovascular and cerebrovascular events were 1.42 (95％CI: 1.02-1.96,P＜0.05),2.26 (95％CI: 1.67-3.04,P＜0.01 ) for those with medium and high risk groups,respectively.Conclusion In diabetic patients,those risk factors as age,hypertension,body mass index,total cholesterol and smoking having been used on ischemic cardiovascular disease,could also be used to predict the occurrence of cardiovascular events.Along with the increasing risk factors,the risk of cardiovascular events incidence also increased. |
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