2型糖尿病患者的氨基末端B型利钠肽前体的水平表达及临床干预的意义

摘要

目的：探讨2型糖尿病患者的氨基末端B型利钠肽前体的水平及临床干预的意义。方法：将405例2型糖尿病患者依据有无心血管疾病分成A、B两组，另设健康对照组C组，比较分析3组间性别、年龄、身高、体重、吸烟、高脂血症、高血压等基本资料并检测NT-proBNP水平。将无心血管疾病的2型糖尿病患者随机分为B1、B2两组进行随诊，随诊时间4年，用字2检验进行组间心血管事件发生率的比较，采用多因素COX比例风险模型对患者进行风险分析。结果：A组NT-proBNP水平为1081.5（791.2~1694.9）pg/mL，B组NT-proBNP水平为309（147.1~594.6）pg/mL，C组NT-proBNP水平为47.5（16.8~97.4）pg/mL，3组患者的NT-proBNP水平的差异均有统计学意义（P<0.05）。校正体重指数、吸烟、高脂血症、高血压等危险因素后，在随诊期间NT-proBNP水平与发生心血管事件的相对危险度为3.476（P<0.05）。B1、B2两组患者心血管事件发生率分别为16.32%和39.39%，两组比较差异有统计学意义（P<0.05）。结论：2型糖尿病患者NT-proBNP水平较高，对2型糖尿病患者进行科学有效的临床干预，可以延缓或减少心血管事件的发生。%Objective:To explore into the expression levels and clinical significance of NT-proBNP in type 2 diabetics.Method:First divided 305 type 2 diabetics into there groups:group A and group B and the healthy control group C.Compared and analyszed the gender,age,height,weight, smoking,hyperlipidemia and etc in these three groups,tested their NT-proBNP levels.Then randomly divided the type 2 diabetics without cardiovascular into group B1 and group B2,and follow up for 4 years. Used χ 2 test and compared the prevalence rates of cardiovascular disease in groups. Multivariate COX proportional hazards model was adopted analyzed the risk of the patients.Result:In group A,the NT-proBNP levels was 1081.5(791.2-1694.9)pg/mL;group B,the NT-proBNP level was 309(147.1-594.6)pg/mL;the NT-proBNP level in group C was 47.5(16.8-97.4)pg/mL.The differences between these three groups were statistically significant(P<0.05).The body index,smoking,hyperlipidemia,hypertension and other risk factors were adjusted,during the follow-up the NT-proBNP levels and the occurrence of cardiovascular events relative risk were 3.476(P<0.05). The incidences of cardiovascular event were 16.32%and 39.39%respectively in group B1 and B2. The differences were statistically significant(P<0.05). Conclusion:The NT-proBNP levels in type 2 diabetics are higher. Scientific and effective clinical intervention in type 2 diabetics can delay or reduce the incidence of cardiovascular events.