血糖控制水平对慢性心力衰竭伴糖尿病患者预后的影响

摘要

Objective:To explore the relationship between blood glucose levels and prognosis in patients with chronic heart failure (CHF)and diabetes mellitus (DM). Methods:A cohort of 228 patients diagnosed as CHF complicated by DM were enrolled in this study. According to blood glycosylated hemoglobin A1c (HbA1c)levels,patients were divided into two groups:standard group (HbA1c < 7.0%) and unstandard group (HbA1c ≥ 7.0%). The incidence of composite major cardiovascular events (MCE)and MCE-free mortality were recorded during follow-up. Results:There was no significant difference in levels of N-terminal pro-brain natriuretic peptide (NT-proBNP)and left ventricular ejection fraction between the two groups.Compared with unstandard group,incidence of MCE was significantly reduced,and MCE-free mortality was increased in standard group (P <0.05). Conclusion:Glycemic control for achieving HbA1c levels of less than 7.0% is beneficial to improve the prognosis of CHF patients with DM.%目的：观察血糖控制水平与慢性心力衰竭合并糖尿病患者预后的关系。方法：选择228例慢性心力衰竭伴糖尿病的患者，根据随访过程中患者糖化血红蛋白（HbA1c）水平分为血糖控制达标组（HbA1c ＜7．0％）与血糖控制不佳组（HbA1c ≥7．0％），比较随访期间两组联合主要心血管事件发生率及无联合主要心血管事件生存率的的差异。结果：随访期间两组患者左室射血分数（LVEF）及 N-末端 B 型利钠肽原（NT-proBNP）水平无统计学差异；与血糖控制不佳组相比，血糖控制达标组的联合主要心血管事件发生率较低（P ＝0．039），无联合主要心血管事件生存率较高（P ＜0．05）。结论：控制血糖使 HbA1c＜7．0％有利于改善慢性心力衰竭合并糖尿病患者的预后。