论文部分内容阅读
目的探讨冠心病合并慢性心力衰竭(CHF)患者糖代谢异常的流行情况,以及糖代谢异常和 CHF 的严重程度的关系。方法研究对象分别来自北京、上海等7个城市,52家医院心内科,连续入选2005年6月至9月问所有符合 CHF 诊断标准的冠心病住院患者,共收集1009例,其中有效病例1004例。调查内容包括口服糖耐量试验、糖化血红蛋白、空腹血糖和血脂等;心功能分级使用美国纽约心脏病学会(NYHA)心功能分级。结果 1004例患者中,过去确诊为糖尿病420(42%)例,新诊断为糖尿病175(17%)例,糖耐量异常208(21%)例,正常201(20%)例。心功能等级随着糖代谢异常程度的增加而增加[等级相关系数(r_s)=0.17,P:0.001]。多因素 logistic 回归分析发现,调整年龄等因素后,过去确诊为糖尿病、新诊断为糖尿病和 IGT 患严重 CHF 的 OR 值分别为1.7(95%CI:1.2～2.4)、1.4(95%CI:0.9～2.1)和1.2(95% CI:0.7～1.7)。结论 CHF 患者的糖代谢异常患病率较高。糖代谢异常和 CHF 的症状轻重相关,糖代谢异常者患严重 CHF 的危险性比血糖正常者高。
Objective To investigate the prevalence of abnormal glucose metabolism in patients with coronary heart disease complicated with chronic heart failure (CHF) and the relationship between abnormal glucose metabolism and the severity of CHF. Methods The subjects were from Beijing, Shanghai and other seven cities, 52 hospitals in the Department of Cardiology, were enrolled consecutively in June 2005 to September all patients with coronary heart disease in line with CHF diagnostic criteria, a total of 1009 cases were collected, of which 1004 cases of effective cases . The survey included oral glucose tolerance test, glycosylated hemoglobin, fasting blood glucose and blood lipids; heart function grading using the New York Heart Association (NYHA) cardiac function classification. Results Of the 1004 patients, 420 (42%) were previously diagnosed with diabetes, 175 (17%) newly diagnosed with diabetes, 208 (21%) with impaired glucose tolerance and 201 (20%) normal. The level of cardiac function increased with the degree of abnormal glucose metabolism [rank correlation coefficient (r_s) = 0.17, P: 0.001]. In the multivariate logistic regression analysis, the odds ratios for the diagnosis of diabetes in the past with newly diagnosed diabetes and severe CHF were 1.7 (95% CI: 1.2-2.4), 1.4 (95% CI: 0.9 ~ 2.1) and 1.2 (95% CI: 0.7 ~ 1.7). Conclusion The prevalence of abnormal glucose metabolism in CHF patients is high. Abnormal glucose metabolism is associated with the severity of symptoms and signs of CHF. Patients with abnormal glucose metabolism have a higher risk of developing severe CHF than those with normal glucose levels.