糖尿病心肌缺血的Logistic回归分析

目的　为探讨糖尿病心肌缺血的相关因素。方法　按十二导联心电图 ,将 93例糖尿病分为无心肌缺血组(A组 )和心肌缺血组 (B组 )。两组病人均完成血压、心脏自主神经功能、尿白蛋白排泄率 (UAE)、红细胞山梨醇(RBCS)、糖化血红蛋白 (HbAlc)、血总胆固醇 (TC)、甘油三酯 (TG)、高密度脂蛋白 (HDL)及其亚类 (HDL3-c及HDL2 c)、低密度脂蛋白 (LDL)、血浆镁 (Mg) ,血浆纤维蛋白原 (Fg)测定。结果　与A组比较 ,B组的病程显著较长 ,收缩压和舒张压 ,UAE ,HbAlc ,RBCs,TG ,TC ,LDL和Fg显著升高 ,而心脏自主神经功能、HDL和Mg显著降低 ,(P <0 0 5或 0 0 1)。两组间性别构成、体重指数、年龄、HDL2 c和HDL3 c无显著差别。Logistic逐步回归分析示与心肌缺血密切相关的主要因素依次为UAE、心脏自主神经病变 (CAND)、TG、dBp和HDL。结论　UAE、dBp和TG升高 ,HDL降低 ,以及CAND是糖尿病人心肌缺血的主要相关因素。防治糖尿病心肌缺血除了控制血糖外 ,还应控制尿白蛋白排泄率和血压 ,调节血脂 ,防治心脏自主神经病变。

Logistic Regression Analysis of Myocardial Ischemia in Patients with Type á Diabetes Mellitus

Objective To study the related factors of myocardial ischemia.Methods According to 12-conductor ECG,93 patients with type 2 diabetes mellitus were divided into two groups:Group A,none myocardial ischemia,61(20/42)cases;Group B,myocardial ischemia,31(9/22)cases.All the patients in both groups received tests on systolic Bp(SBp),diastolic Bp(DBp),BMI,cardiac sympathetic activities(SA),cardiac parasympathetic activities(PA),urinary albumin excretion(UAE),HbA 1c ,red cell sorbitol(RBCS),total cholesterol(TC),triglycerol(T G),low density lipoprotein cholesterol(LDL c),high density lipoprotein cholesterol(HDL c)and its composition HDL 2-c and HDL 3-c ,plasma fibrinogen(Fg)and magnesium(Mg).Results Compared with Group A,patients in Group B had longer duration,their SBp,DBp,UAE,HbA 1c ,RBCS,TG,TC,LDL and Fg.showed a significant increase while their SA,PA,HDL and Mg decreased a great deal(P<0.05 or 0.01).There were no significant varieties in sex composition,weight,age,HDL 2-c and HDL 3-c between the two groups.Logistic regression suggested that the main factors related closely to myocardial ischemia were UAE,cardiac autonomic neuropathy,TG,DBp and HDL.Conclusion The increase of UAE,DBp and TG,and the decrease in HDL and cardiac autonomic neuropathy are the main factors of myocardial ischemia.