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冠心病和高血压患者中糖代谢异常的门诊筛查流程及现状调查 被引量:14

Glucometabolic abnormalities survey among outpatients without previous diabetes diagnosis and with coronary artery disease and hypertension
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摘要 目的在未诊断为糖尿病的心内科门诊患者中进行规范的血糖筛查,以了解心内科门诊患者糖代谢异常的患病情况及临床门诊筛查流程的现状。方法在全国范围内选取11家符合资质的综合医院心内科,选取年龄18岁以上,且具有较高糖尿病患病风险的高血压及冠心病患者,收集一般资料及人口学数据、疾病诊断及病史信息,在随机血糖检测后,对空腹随机血糖≥6.1mmol/L和餐后随机血糖≥7.8mmol/L的患者进行口服葡萄糖耐量试验(OGTT)筛查、人体测量和问卷调查。患病率采用调整的患病率。结果11家中心共人组7778例患者,经空腹血糖和随机血糖初筛后,预约OGTr筛查的患者为3861例,实际进行OGTT筛查的患者为3019例,占预约人数的78.2%。进行OGTT筛查的3019例患者,符合糖尿病诊断标准的为1287例,糖尿病患病率为18.64%(1287/6904),冠心病患者中糖尿病的患病率为19.87%(95/478),高血压患者的糖尿病患病率为9.22%(352/3819),高血压合并冠心病患者的糖尿病患病率为14.81%(153/1033);符合糖耐量减低(IGT)诊断标准的患者为996例,IGT患病率为14.43%(996/6904)。153例随机血糖低于7.8mmol/L的患者也进行了OGTT筛查,结果发现有40例符合糖尿病的诊断标准,检出率为26.14%(40/153)。结论心内科就诊的高血压和冠心病患者中,糖尿病的患病率较高,建议对心内科就诊的所有冠心病及高血压患者进行OGTT筛查,以提高心血管病患者糖耐量异常及糖尿病的早期诊断率,防止空腹血糖正常的已患有2型糖尿病或糖耐量异常的心血管病患者漏诊。采用0GTT试验进行糖尿病筛查是可行的,患者的依从性较佳。 Objective To explore the status of glucometabolic abnormalities in cardiological outpatients without previous diabetes diagnosis and with coronary artery disease (CAD) and hypertension. Methods Patients without previous diagnosis of diabetes but with hypertension and CAD aged 18 years or above were recruited from cardiology departments of 11 general hospitals in China. Demographic data, disease diagnosis and medical history were collected. Physical examination and questionnaire survey were performed after the random blood glucose test. Oral glucose tolerance test (OGTT) examination was made for patients with fasting blood glucose ≥6. 1 mmol/L or postprandial random glucose ≥7. 8 mmol/L. Adjusted prevalence rates were used in the study. Results A total of 7778 patients were included in 11 centers. After preliminary screening by fasting blood glucose and random blood glucose tests, 3861 patients were required to take OGTT, and 3019 (78. 2% ) patients actually took the test. 1287 out of 3019 patients screened with OGTT were diagnosed with diabetes, and the adjusted diabetes prevalence rate was 18.64% (1287/6904). The prevalence rate of diabetes was 19. 87% (95/478), 9. 22% (352/3819) and 14. 81% (153/1033) in patients with CAD, hypertension, and CAD combined with hypertension, respectively. A total of 996 patients were diagnosed with impaired glucose tolerance (IGT) and its prevalence was 14. 43% (996/6904). Of the enrolled population, 153 patients with random blood glucose lower than 7.8 mmol/L were also screened with OGTT test, 26. 14% (40/153) patients met the diagnostic criteria of diabetes. Conclusion A high prevalence of diabetes is found in patients without previous diagnosis of diabetes and with hypertension and CAD consulting at cardiology departments. We thus suggest to perform OGTT in this patient cohort to improve the early diagnosis of IGT and diabetes, and prevent missed detection of type 2 diabetes mellitus or IGT in cardiovascular patients with normal fasti
作者 陈韵岱 李丹丹 董蔚 李莉 罗俊 杨杰孚 屈正 李曙光 成肖杰 季汉华 赵燕 黄党生 CHEN Yun-dai , LI Dan-dan, DONG Wei, LI Li, LUO dun, YANG Jie-fu, QU Zheng, LI Shu-guang, CHENG Xiao-jie, JI Han-hua, ZHAO Yan, HUANG Dang- sheng.( Department of Cardiology, Chinese People's Liberation Army General Hospital, Beijing 100853, China)
出处 《中华心血管病杂志》 CAS CSCD 北大核心 2013年第12期995-999,共5页 Chinese Journal of Cardiology
关键词 冠状动脉疾病 高血压 糖尿病 患病率 Coronary disease Hypertension Diabetes Prevalence
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参考文献12

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