门诊2型糖尿病合并冠心病患者临床特点分析

目的探讨门诊2型糖尿病合并冠心病患者的临床特点。方法回顾性分析中日友好医院2007年1月至2007年12月内分泌门诊528例2型糖尿病患者的临床资料。根据是否合并冠心病将患者分为冠心病组（81例）（男40例，女41例）和无冠心病组（447例）（男249例，女198例）。观察比较两组患者的临床资料。并通过logistic回归分析2型糖尿病患者冠心病的独立相关因素。结果与无冠心病组比较，冠心病组年龄较高[分别为（60±12）和（694-8）岁，t=-8．64，P〈0．05]，糖尿病病程较长[分别为（9±7）和（12±7）年，t=-4．44，P〈0．05]，糖化血红蛋白水平较高（分别为6．8％4-1．1％和7．4％±1．2％，t=-3．38，P〈0．05），收缩压增高[分别为（1304-15）和（134±15）mmHg（1mmHg=0．133kPa），t=-2．26，P〈0．05]；冠心病组高血压、高血脂症、脑卒中及冠心病阳性家族史的发生率均较高（X^2=14．29、9．47、25．01、7．56，均P〈0．05）。2组血压和血脂控制达标率相当，但HbAlC〈7．0％比例在冠心病组明显低于无冠心病组（分别为48．1％和68．2％，0=12．18，P〈0．05）。Logistic多元回归分析表明年龄、糖尿病病程、HbAlC、合并脑卒中、收缩压以及他汀药的使用是2型糖尿病患者发生冠心病的独立相关因素（OR=1．08、1．11、1．47、2．72、1．03和2．41，均P〈0．05）。结论门诊2型糖尿病合并冠心病的患者表现多种危险因素并存，对于这些患者不能仅注重血糖的管理，还要注意控制血压、血脂并重视他汀类药物的使用。

Clinical features of outpatients with type 2 diabetes mellitus and coronary heart disease

Objective To investigate the clinical characteristics in outpatients with type 2 diabetes mellitus and coronary heart disease （CHD）. Methods Retrospectively analyzed the clinical data of 528 outpatients with type 2 diabetes mellitus enrolled from January to December in 2007 in outpatients. Patients were divided into two groups according to CHD history： CHD group （n =81,40 males and 41 females） and non-CHD group （n =447, 249 males and 198 females）. The clinical characteristics of the patients were analyzed. Logistic regression analysis was applied to explore independent correlation factor for CHD in patients with type 2 diabetes. Results Compared with patients in non-CHD group, patients in CHD group were older（ （60 ± 12 ） and （ 69 ± 8 ） years, respectively, t = - 8.64, P 〈 0. 05 ）, with longer duration of diabetes（ （9 ± 7 ） and （ 12 ± 7 ） years, respectively, t = - 4. 44, P 〈 0.05 ）, higher glycated hemoglobin Alc （HbAlc） （6. 8% ±1.1% and 7.4% ±1.2%, respectively, t = -3.38, P〈0.05）, and higher systolic blood pressure （ （ 130 ± 15） and （ 134 ± 15） mm Hg（ 1 mm Hg = 0. 133 kPa）, respectively, t = - 2.26, P 〈 0. 05 ） ; And the patients in CHD group had higher incidence of hypertension, dyslipidemia, stroke and positive family history of CHD（X^2 = 14. 29, 9. 47, 25.01, 7.56, all P 〈 0. 05 ）. The standard- reaching rate of blood pressure and blood lipid in the two groups were similar; but the rate of HbAlc 〈 7. 0% was much lower in CHD group than that in non-CHD group（48.1% and 68.2% ,respectively, ~2 = 12. 18, P 〈 0.05 ）. Logistic regression analysis showed that age, duration of diabetes, HbAlc, stroke, systolic pressure and the use of statins were correlation factors for CHD （ OR = 1.08,1.11,1.47,2. 72,1.03 and 2.41 ,respectively, all P 〈 0. 05 ）. Conclusions Outpatients with diabetes and CHD are concomitant withmuhiple risk factors, for these patients, more attention should be paid to the management of blood glucose, blood pressure, blood lipid and the use of statins.