老年心脑血管疾病患者的血糖筛查及临床分析

摘要

Objective To screen the glucose metabolism status and do clinical study in elder cardio-cerebral-vascular diseases patients. Methods Al inpatients with cardio-cerebral-vascular diseases in cadre ward of our hospital were consecutively recruited from Nov 1,2011 to Oct 31.2012.a total of 269 patients with cardio-cerebral-vascular diseases were included in the study. The clinical information was compiled. Among al the patients,118 ones had diabetes melitus (DM) history. 5 ones were diagnosed DM through fasting plasma glucose (FPG). The patients undiagnosed DM would perform 2-hr plasma glucose (2hPG) test to characterize the glucose metabolism status. Results The prevalences of patients with DM and impaired glucose regulation (IGR) were 51.30% and 22.30% in inpatients with cardio-cerebral-vascular diseases, respectively. The total prevalence of abnormal glucose metabolism was 73.60%.Without the use of 2-hr plasma glucose test, 66.67% newly diagnosed IGR and 75% newly diagnosed DM would remain undiagnosed by FPG detection alone. The 2hpg and FPG are interrelated. Conclusion The frequency of disturbed glucose metabolism is considerably high in elder cardio-cerebral-vascular diseases patients, especialy in patients with high fasting plasma glucose.%目的：对我院老年病房住院心脑血管疾病患者进行血糖筛查，并进行临床研究。方法选取老年病房2011年11月到2012年10月所有纳入心脑血管病诊断标准的住院患者共269例，收集临床资料。其中，既往确诊糖尿病患者118例，经空腹血糖（F P G）确诊糖尿病5例，未确诊糖尿病患者行餐后2小时血糖（2HPG）检查，以判断糖代谢状态。结果老年心脑血管疾病患者中糖尿病检出率为51.30%，糖调节受损检出率为22.30%，总的糖代谢异常检出率为73.60%。若不进行餐后2小时血糖检测，仅依靠FPG检测，将有75%的新发糖尿病漏诊，66.67%的新发糖调节受损漏诊。通过多项分类Logistic回归分析发现餐后2小时血糖与空腹血糖密切相关。结论老年心脑血管疾病患者绝大多数合并糖代谢异常，通过餐后2小时血糖检查能够发现这种现象。餐后2小时血糖应该作为老年心脑血管疾病患者的常规检查项目，对于空腹血糖较高的患者更应如此。