摘要
目的：探讨糖尿病腹膜透析患者糖化血红蛋白（ HbA1C ）水平与颈动脉钙化及心血管事件的关系。方法将60例基础病为糖尿病肾病的腹膜透析患者按照HbA1C的水平分成两组，检测血清HbA1C水平及相关因素，所有的患者均接受颈动脉斑块超声检测，随访1年，观察两组患者血清HbA1C水平、颈动脉钙化的动态变化及心血管事件发生情况。结果低HbA1C组患者颈动脉钙化及心血管事件发生均低于高HbA1C组（ P＜0.05）；随访1年，低HbA1C组的颈动脉钙化进展及新发心血管事件明显少于高HbA1C组（P＜0.05），logistic 回归分析显示血清HbA1C升高是颈动脉钙化发生的重要影响因素（OR＝1.72，95％CI 0.92～3.87， P＝0.024），而HbA1C升高（OR＝1.43，95％CI 0.73～3.46， P＝0.012）及颈动脉钙化（OR＝3.17，95％CI 1.38～5.99， P＝0.018）是糖尿病腹膜透析患者心血管事件发生的重要影响因素。结论血清HbA1C水平与糖尿病腹膜透析患者颈动脉钙化发生关系密切，HbA1C升高及颈动脉钙化是此类患者心血管事件发生的重要影响因素。
Objective To investigate the correlations among HbA 1C , carotid plaques and cardiovascular events in peritoneal dialysis patients with diabetes mellitus .Methods Sixty peritoneal dialysis patients , whose original diseases were diabetes mellitus, were divided into two groups according to the serum HbA 1C level.HbA1C and other serum related parameters were assessed , and carotid intima-media thickness （ cIMT） was checked by B-mode ultrasonography .After one year follow-up, the associations among the serum HbA 1C level, deterioration of cIMT and newly -occurring cardio-vascular events were analyzed .Results Significantly higher cIMT and cardiovascular event rate were observed in high HbA1C group than low HbA1C group （P〈0.05）.After one year follow-up, progression of cIMT and newly occurring car-diovascular events were significantly higher in high HbA 1C group than low HbA1C group.Logistic regression analysis indica-ted that serum HbA1C level was risk factor of cIMT （OR=1.72, 95%CI：0.92-3.87, P=0.024）;while serum HbA1C （OR=1.43, 95%CI：0.73-3.46, P=0.012） level and cIMT （OR=3.17, 95%CI：1.38-5.99, P=0.018） were risk factors of cardiovascular events in peritoneal dialysis patients with diabetes mellitus .Conclusion Serum HbA1C is a risk factor of carotid plaques , and serum HbA1C and cIMT were risk factors of cardiovascular events in peritoneal dialysis with diabetes mellitus .
出处
《广东医学》
CAS
CSCD
北大核心
2014年第9期1345-1347,共3页
Guangdong Medical Journal
基金
广东省科技计划项目(编号:2007B031503009)
关键词
糖尿病
腹膜透析
糖化血红蛋白
颈动脉钙化
diabetes mellitus
peritoneal dialysis
HbA1C
vascular calcification
