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目的:探讨2型糖尿病(DM)合并冠心病(CHD)的老年患者在急诊科观察的临床特点。方法:回顾性分析2011年12月至2012年12月在广州市第一人民医院急诊科观察的880例2型DM老年患者的临床资料。根据是否合并CHD将患者分为CHD组(共318例)和无CHD组(共562例),观察比较两组患者的临床资料,通过logistic回归分析2型DM老年患者CHD的独立相关因素。结果:与无CHD组比较,CHD组年龄较高(79±7 vs73±8岁P<0.05),DM病程较长(16±7 vs 12±7年,P<0.05),糖化血红蛋白(Hb A1c)水平较高(7.8±1.5%vs 6.8±1.2%,P<0.05),收缩压(SBP)较高(160±17 vs138±15mm Hg,P<0.05),CHD阳性家族史和DM阳性家族史的发生率较高(P值都<0.05);Logistic多元回归分析表明年龄、DM病程、SBP、低密度脂蛋白胆固醇(LDL-C)水平、Hb A1c水平、CHD家族史和合并脑卒中是2型DM老年患者发生CHD的独立相关因素。结论:在急诊科观察的2型DM老年患者合并CHD时表现出多种危险因素并存,临床上要控制血糖、血压和血脂,重视对病程长、有CHD家族史、合并脑卒中的DM患者的管理。
Objective: To investigate the clinical features of elderly patients with type 2 diabetes mellitus (DM) with coronary heart disease (CHD) observed in the emergency department. Methods: The clinical data of 880 elderly patients with type 2 DM who were observed in the emergency department of Guangzhou First People ’s Hospital from December 2011 to December 2012 were retrospectively analyzed. The patients were divided into CHD group (318 cases) and non-CHD group (562 cases) according to whether CHD was merged or not. The clinical data of two groups were observed and compared, and the independent related factors of CHD in type 2 DM elderly patients were analyzed by logistic regression. Results: The CHD group was older (79 ± 7 vs 73 ± 8 years, P <0.05), longer duration of DM (16 ± 7 vs 12 ± 7 years, P <0.05), and Hb A1c (7.8 ± 1.5% vs 6.8 ± 1.2%, P <0.05), SBP (160 ± 17 vs138 ± 15mm Hg, P <0.05), positive CHD family history and DM positive family history (P <0.05). Logistic multiple regression analysis showed that age, DM duration, SBP, LDL-C, Hb A1c, family history of CHD and combined stroke were 2 Type DM in elderly patients with CHD independent factors. CONCLUSION: In the elderly with type 2 diabetes mellitus observed in the emergency department, there are many risk factors coexisting in CHD. To control blood sugar, blood pressure and blood lipid in clinic, we should pay more attention to DM patients with long history, family history of CHD and stroke management.