2型糖尿病患者周围神经病变与心血管疾病的相关性

摘要

目的:探讨2型糖尿病(T2DM)患者周围神经病变(DPN)与心血管疾病(CVD)的相关性.方法:选择2014年1月至2016年7月于我社康中心接受治疗的375例T2DM患者为研究对象.采用调查表收集人口学特征、收缩压(SBP ) 、血脂、血糖、肌电图、 CVD等数据.根据是否合并 CVD ,患者被分为 CVD组(54例)和非CVD组(321例) .分析各指标与CVD风险的相关性,采用多因素Logistic回归分析影响CVD风险的独立危险因素.结果: 375例T2DM患者中, 54例(14.4%)合并CVD .与非CVD组比较, CVD组年龄≥65岁、空腹血糖(FBG)异常、餐后2h血糖(2hPG)异常、糖化血红蛋白(HbA1c)异常、收缩压(SBP)异常发生率均显著升高(P＜0.05或＜0.01). Spearman相关分析示:年龄、 FBG 、 2hPG 、 DPN 、 SBP和HbA1c与CVD风险呈显著正相关(r＝0.612～0.735 ,P均＝0.001).多因素Logistic回归分析示:DPN 、 FBG异常和2hPG异常是CVD的独立危险因素(OR＝1.248～2.023 ,P均＜0.05).结论:DPN是2型糖尿病患者发生CVD的独立危险因素之一,临床上应重视此类患者CVD的预防、筛查和早期治疗.%Objective :To explore correlation between diabetic peripheral neuropathy (DPN) and cardiovascular disea-ses (CVD) in patients with type 2 diabetes mellitus (T2DM).Methods :A total of 375 T2DM patients ,who were treated in our community health service center from Jan 2014 to Jul 2016 ,were selected .Demographic characteris-tics ,systolic blood pressure (SBP) ,blood lipids ,blood glucose ,electromyogram and CVD were collected in all sub-jects using questionnaire .According to complicated CVD or not ,patients were divided into CVD group (n＝54) and non-CVD group (n＝321).Correlation among all indexes and CVD risk were analyzed .Multifactor Logistic regres-sion analysis was used to analyze independent risk factors for CVD risk .Results :Among the 375 T2DM patients ,54 cases (14. 4%) were complicated with CVD .Compared with non-CVD group ,there were significant rise in age≥65 years ,abnormal fasting blood glucose (FBG) , abnormal 2h postprandial blood glucose (2hPG) , abnormal glycosy-lated hemoglobin A1c (HbA1c) and SBP in CVD group , P＜0.05 or ＜0.01 .Spearman correlation analysis indica-ted that age ,FBG ,2hPG ,DPN ,SBP and HbA1c were significant positively correlated with CVD risk (r＝0.612～0.735 , P＝0.001 all).Multifactor Logistic regression analysis indicated that DPN , abnormal FBG and abnormal 2hPG were independent risk factors for CVD (OR＝1.248～2.023 , P＜0.05 all).Conclusion : Diabetic peripheral neuropathy is one of the independent risk factors for CVD in T2DM patients .Attention should be paid to preven-tion ,screening and early treatment of CVD in these patients in clinic .