论文部分内容阅读
目的探讨老年女性2型糖尿病(type 2 diabetes mellitus,T2DM)患者血脂代谢异常与冠心病的关系。方法收集2010年4月—2014年5月在本院内科住院治疗的老年女性T2DM患者168例,根据患者是否合并冠心病分为单纯T2DM组(n=96),T2DM并冠心病组(n=72)。另外选取40例健康人作为健康组,抽取肘部静脉血并分析。比较三组研究对象的血脂指标情况,应用Pearson相关性分析T2DM患者并发冠心病与血脂指标(TG、HDL-C、Apo-A1、Apo-B)的关系。计量资料采用t检验,血脂指标与冠心病的关系采用Pearson相关性分析,P<0.05为差异有统计学意义。结果健康组TC、TG、HDL-C、LDL-C、Apo-A1、Apo-B水平分别为(4.9±0.8)、(1.2±0.2)、(1.3±0.2)、(2.6±0.7)mmol/L、(1.4±0.2)、(0.8±0.1)g/L,单纯T2DM组分别为(5.3±1.0)、(1.8±0.4)、(1.0±0.1)、(2.9±0.9)mmol/L、(1.0±0.2)、(1.0±0.2)g/L,T2DM并冠心病组分别为(5.4±1.1)、(2.1±0.6)、(0.8±0.2)、(3.4±1.0)mmol/L、(0.7±0.1)、(1.4±0.2)g/L,单纯T2DM组及T2DM并冠心病组血TC、TG、LDL-C、Apo-B水平均明显高于健康组,而HDL-C、Apo-A1水平则明显低于健康组,T2DM并冠心病组血TG、LDL-C、Apo-B水平均明显高于单纯T2DM组,而HDL-C、Apo-A1水平则明显低于单纯T2DM组,对比差异均有统计学意义(均P<0.05)。T2DM并发冠心病的风险与TG、LDL-C、Apo-B呈正相关(r=0.492、0.480,0.751,P<0.05),而与HDL-C、Apo-A1呈负相关(r=-0.815、-0.698,P<0.05)。结论血脂异常会增加患者并发冠心病变的风险,因此T2DM患者在严格控制血糖水平的同时,应严密监测血TG、LDL-C、Apo-B、HDL-C、Apo-A1水平的变化,加强调脂治疗,最终实现降低T2DM患者并发冠心病,改善其预后的目标。
Objective To investigate the relationship between dyslipidemia and coronary heart disease in elderly type 2 diabetes mellitus (T2DM) patients. Methods A total of 168 elderly T2DM patients hospitalized in our department from April 2010 to May 2014 were enrolled in this study. According to whether patients with coronary heart disease were complicated with T2DM or not (n = 96), patients with T2DM and coronary heart disease (n = 72). In addition, 40 healthy people were selected as healthy group, elbow venous blood was drawn and analyzed. The levels of serum lipids in three groups were compared. The Pearson correlation was used to analyze the relationship between coronary heart disease and blood lipid (TG, HDL-C, Apo-A1, Apo-B) in T2DM patients. Measurement data using t test, blood lipid indicators and coronary heart disease using Pearson correlation analysis, P <0.05 for the difference was statistically significant. Results The levels of TC, TG, HDL-C, LDL-C, Apo-A1 and Apo-B in healthy group were 4.9 ± 0.8, 1.2 ± 0.2, 1.3 ± 0.2 and 2.6 ± 0.7 mmol / L, (1.4 ± 0.2) and (0.8 ± 0.1) g / L, respectively, and were significantly higher in T2DM group than those in T2DM group (5.3 ± 1.0, 1.8 ± 0.4, 1.0 ± 0.2) and (1.0 ± 0.2) g / L, respectively. The mean arterial pressure was (5.4 ± 1.1), (2.1 ± 0.6), (0.8 ± 0.2) and ± 0.1) and (1.4 ± 0.2) g / L respectively. The levels of TC, TG, LDL-C and Apo-B in T2DM and T2DM combined with coronary heart disease were significantly higher than those in healthy subjects The levels of TG, LDL-C and Apo-B in T2DM and CHD group were significantly higher than those in T2DM group, while the levels of HDL-C and Apo-A1 in T2DM group were significantly lower than those in T2DM group The differences were statistically significant (all P <0.05). The risk of T2DM complicated with coronary heart disease was positively correlated with TG, LDL-C and Apo-B (r = 0.492,0.480,0.751, P <0.05), but negatively correlated with HDL- -0.698, P <0.05). Conclusions Dyslipidemia may increase the risk of patients with coronary heart disease. Therefore, the levels of TG, LDL-C, Apo-B, HDL-C and Apo-A1 in T2DM patients should be closely monitored while the blood glucose level is strictly controlled. Emphasize lipid therapy, and ultimately achieve the goal of reducing coronary artery disease in patients with T2DM and improve their prognosis.