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踝臂指数及经皮氧分压预测2型糖尿病心脑血管事件

Ankle brachial index and transcutaneous oxygen pressure as potential predictors of cardiovascular events in type 2 diabetes mellitus
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摘要 目的探讨踝臂指数(ABI)及经皮氧分压(TcPO2)预测2型糖尿病(T2DM)心脑血管事件风险的价值。方法采用前瞻性随访研究,选取海南医学院第二附属医院2015年1月—2016年6月住院患者中排除已并发心脑血管疾病及其他严重疾病的T2DM患者198例,测定ABI及TcPO2并院外随访,终点为主要不良心血管事件(MACE)。采用Cox比例风险模型探索T2DM患者MACE的风险因子;采用生存曲线分析ABI与TcPO2预测T2DM心脑血管事件风险的价值。结果失访18例,共180例患者纳入分析,平均随访(19.5±4.7)个月,其中28例(15.6%)T2DM患者发生了MACE。生存分析曲线表明,ABI≤0.9组发生MACE(P<0.01);TcPO2正常组及异常组的生存曲线比较差异无统计学意义(P>0.05);Cox回归分析表明ABI可作为T2DM心脑血管事件的风险预测因子(RR=0.142,P<0.01),且这种预测价值在校正年龄、吸烟史、糖尿病病程、收缩压、总胆固醇(TC)后仍然存在(RR=0.176,P<0.05);TcPO2与T2DM患者MACE无显著相关性(RR=1.544,P>0.05)。结论 ABI可作为2型糖尿病心脑血管事件的风险预测指标,尚无法证明TcPO2对心脑血管事件具备预测价值。 Objective To explore the potential value of ankle brachial index(ABI) and transcutaneous oxygen pressure(TcPO2) as predictor of cardiovascular events in type 2 diabetes mellitus. Methods This was a prospective follow-up study.Hospitalized patients in The Second Affiliated Hospital of Hainan Medical University from January 2015 to June 2016 were selected, if they were excluded with cardiovascular and other severe diseases, and 198 type 2 diabetic patients were included.ABI and TcPO2 of these patients were measured and followed upout of hospital. The end of follow up was major adverse cardiovascular events(MACE). Cox proportional hazard model was used to explore risk factors of MACE in type 2 diabetes and survival curves to analyze ABI and TcPO2 as predictors of cardiovascular events in type 2 diabetes. Results Eighteen patients with lost visits were excluded, and a total of 180 patients were included in the analysis.After a mean follow-up period of(19.5±4.7) months, 28 patients(15.6%) had MACE. Survival analysis suggested that the ABI≤0.9 group had higher incidence of MACE compared with the ABI>0.9 group(66.7% vs 19.8%, P< 0.01), while groups between normal and abnormal TcPO2 had no significant difference in MACE(P>0.05). Cox regression analysis showed that ABI had predictive value for the occurrence of MACE(RR=0.142, P<0.01), when adjusted for age, smoking history, diabetes duration, systolic blood pressure,and total cholesterol(TC) level, this value still existed(RR=0.176, P<0.05). There was no significant correlation between TcPO2 and MACE in T2 DM patients(RR=1.544,P>0.05). Conclusions ABI can be a predictor of MACE in T2 DM patients, while TcPO2 could not be proved to have predictive value for cardiovascular events.
作者 陈显英 陈宗存 陈清华 符茂雄 CHEN Xianying;CHEN Zongcun;CHEN Qinghua;FU Maoxiong(Department of Endocrinology,The Second Affiliated Hospital of Hainan Medical University,Haikou,Hainan 570311,China)
出处 《中国热带医学》 CAS 2019年第3期258-262,共5页 China Tropical Medicine
基金 海南省卫计委面上项目(No.14A200070).
关键词 踝臂指数 经皮氧分压 2型糖尿病 心脑血管事件 Ankle brachial index transcutaneous oxygen pressure type 2 diabetes mellitus cardiovascular events
作者简介 陈显英(1983—),女,硕士,副主任医师,研究方向:内分泌及代谢性疾病;通信作者:符茂雄,E-mail:fmx66809185@163.com。
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