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目的 2型糖尿病(T2DM)是心房颤动(AF)的独立危险因素,本研究探讨T2DM患者血糖控制程度与房颤的关系。方法稳定性冠心病(CAD)患者,除外心功能Ⅳ级的T2DM患者,排除既往有AF病史或入院心电图(ECG)显示有房颤、房扑的患者,590例患者作为T2DM组;对照组为排除2型糖尿病和糖耐量异常的CAD患者共300例。记录所有患者的基线资料,分析其1年内各组患者AF的发生率。结果各组患者基线资料存在差异,年龄、男性、入院心率、吸烟史、体重指数在T2DM组中较对照高,在高HbA1c组中更高;1年内新发AF的发生率同样在高HbA1c组中最高,在非T2DM组中最低,多因素回归分析显示,作为连续变量HbA1c是AF发生的独立危险因素,作为分类变量时HbA1c水平同样是AF发生的独立危险因素。结论 T2DM患者AF发生风险增加,血糖水平控制不良的T2DM患者AF风险进一步增加。
Objective T2DM is an independent risk factor of atrial fibrillation (AF). This study was to investigate the relationship between the degree of glycemic control and atrial fibrillation in T2DM patients. Methods Patients with stable coronary heart disease (CAD) and T2DM except for cardiac function grade Ⅳ were excluded from the patients with previous history of AF or admission electrocardiogram (ECG) showing atrial fibrillation and atrial flutter, and 590 patients as T2DM group. The control group was A total of 300 CAD patients with type 2 diabetes and impaired glucose tolerance were excluded. Baseline data were recorded for all patients and analyzed for incidence of AF in each group within 1 year. Results The baseline data of each group were different. Age, male, admission heart rate, smoking history and body mass index were higher in T2DM group than in control group and higher in HbA1c group. The incidence of new-onset AF in 1 year was also higher in HbA1c group In the non-T2DM group, multivariate regression analysis showed that as a continuous variable HbA1c is an independent risk factor for AF, as a classification variable HbA1c level is also an independent risk factor for AF. Conclusion The risk of AF in T2DM patients is increased, and the risk of AF in T2DM patients with poorly controlled blood glucose level is further increased.