【摘要】：目的探討非瓣膜性心房顫動(dòng)(NVAF)并發(fā)2型糖尿病(T2DM)患者的臨床特點(diǎn),以及T2DM對(duì)NVAF患者生存狀況的影響。方法選取2014年1月至2015年9月天津市胸科醫(yī)院收治的646例NVAF患者,根據(jù)患者是否合并T2DM將其分為T2DM組(n=110)與非T2DM組(n=536)。比較兩組的臨床資料及隨訪1年腦梗死、心血管死亡的發(fā)生率,采用多因素Cox比例風(fēng)險(xiǎn)模型篩選影響患者1年內(nèi)腦梗死、心血管死亡發(fā)生的因素。結(jié)果 T2DM組患者的年齡、體質(zhì)量指數(shù),高血壓、冠心病、短暫性腦缺血發(fā)作(TIA)或腦卒中、高脂血癥的發(fā)生率,以及阿司匹林、他汀類降脂藥的應(yīng)用率均明顯高于非T2DM組,差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。隨訪1年,T2DM組患者心血管死亡的發(fā)生率為14.5%,明顯高于非T2DM組的5.1%(P0.05)。T2DM組、非T2DM組患者腦梗死的發(fā)生率分別為12.7%、6.4%,組間比較差異無統(tǒng)計(jì)學(xué)意義(P0.05)。多因素Cox回歸分析結(jié)果表明,年齡、TIA或腦卒中、T2DM是腦梗死發(fā)生的獨(dú)立危險(xiǎn)因素(P0.05)。年齡、心力衰竭、T2DM是心血管死亡發(fā)生的獨(dú)立危險(xiǎn)因素,而血管緊張素轉(zhuǎn)換酶抑制劑/血管緊張素Ⅱ受體阻滯劑是其獨(dú)立保護(hù)因素(P0.05)。結(jié)論合并T2DM可增加NVAF患者腦梗死與心血管死亡的風(fēng)險(xiǎn)。
[Abstract]:Objective to investigate the clinical features of (NVAF) complicated with type 2 diabetes mellitus (T2DM) and the influence of T2DM on the survival status of NVAF patients with non-valvular atrial fibrillation. Methods from January 2014 to September 2015, 646 patients with NVAF were selected and divided into T2DM group (n = 110) and non-T2DM group (n = 536) according to whether they were combined with T2DM. The clinical data and the incidence of cerebral infarction and cardiovascular death were compared between the two groups. The risk factors of cerebral infarction and cardiovascular death within one year were screened by multivariate Cox proportional risk model. Results the age, body mass index, hypertension, coronary heart disease, transient ischemic attack of (TIA) or stroke, hyperlipidemia and the application rate of aspirin and statins in T2DM group were significantly higher than those in non-T2DM group. The difference was statistically significant (P0.05). After 1 year follow-up, the incidence of cardiovascular death in T2DM group was 14.5%, which was significantly higher than that in non-T2DM group (5.1%). The incidence of cerebral infarction in T2DM group and non-T2DM group was 12.7% and 6.4%, respectively. There was no significant difference between the two groups (P0.05). Multivariate Cox regression analysis showed that age, TIA or stroke, T2DM were independent risk factors of cerebral infarction (P0.05). Age, heart failure and T2DM were independent risk factors for cardiovascular death, while angiotensin converting enzyme inhibitors / angiotensin 鈪，

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