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目的探讨基线收缩压水平对糖尿病人群新发心脑血管事件的影响。方法本研究以参加2006-07-2007-10健康查体的101 510名开滦集团职工中的8306例空腹血糖≥7.0或<7.0 mmol/L但已确诊为糖尿病,正在使用降糖药物的人群作为观察对象,随访38~53(48.1±3.1)月,随访期间每半年收集一次新发心脑血管事件情况。分析基线收缩压水平对糖尿病人群新发心脑血管事件的影响。结果随着基线收缩压水平增高,糖尿病人群的平均年龄、体质量指数、三酰甘油、高密度脂蛋白胆固醇、总胆固醇、低密度脂蛋白胆固醇水平逐渐增高(P<0.01或P<0.05)。与基线收缩压<120组、120~<130组和≥140组相比,130~<140 mm Hg组总心脑血管事件、脑梗死事件、心肌梗死事件和脑出血事件发生率最低,其中总心脑血管事件和脑梗死事件发生率的差异有统计学意义(P<0.05)。Cox比例风险回归分析显示,在糖尿病合并高血压人群中,与基线收缩压130~<140组相比,<120组、120~<130组和≥140 mm Hg组发生总心脑血管事件的RR值分别为5.37(95%CI2.24~12.87,P<0.01)、2.41(95%CI1.11~5.22,P<0.05)和2.43(95%CI1.35~4.36,P<0.01);与基线收缩压130~<140组相比,<120组和≥140 mm Hg组发生脑梗死的RR值分别为6.16(95%CI2.05~18.55,P<0.01)和2.65(95%CI1.24~5.70,P<0.01)。结论基线收缩压水平可影响糖尿病人群心脑血管事件发生率,糖尿病合并高血压人群中收缩压130~139 mm Hg组总心血管事件和脑梗死事件发生率最低。
Objective To investigate the effect of baseline systolic blood pressure (SBP) on new cardiovascular and cerebrovascular events in diabetic population. Methods In this study, 8306 cases of 101 510 Kailuan Group employees who participated in the 2006-07-2007-10 health check-up were diagnosed as diabetic and were using hypoglycemic drugs when their fasting blood glucose was 7.0 or 7.0 mmol / L The subjects were followed up for 38-53 months (48.1 ± 3.1 months). Cardiac and cerebrovascular events were collected every six months during the follow-up period. Analysis of the impact of baseline systolic blood pressure on new cardiovascular and cerebrovascular events in diabetic population. Results As the systolic blood pressure increased at baseline, the average age, body mass index, triglyceride, high density lipoprotein cholesterol, total cholesterol and low density lipoprotein cholesterol in diabetic patients increased gradually (P <0.01 or P <0.05). Compared with baseline systolic blood pressure <120, 120 ~ <130 and ≥140, the incidence of total cardiovascular events, cerebral infarction, myocardial infarction and cerebral hemorrhage was the lowest in 130 ~ <140 mm Hg group, of which total The incidence of cardiovascular and cerebral infarction events were statistically significant (P <0.05). Cox proportional hazards regression analysis showed that in patients with diabetes mellitus and hypertension, compared with baseline systolic blood pressure 130 ~ <140, RR <120, <130 and ≥140 mm Hg group had cardiovascular events (95% CI 2.24-12.87, P <0.01), 2.41 (95% CI 1.11-5.22, P <0.05) and 2.43 (95% CI 1.35-4.46, P <0.01) The RR of cerebral infarction was <6.16 (95% CI2.05 ~ 18.55, P <0.01) and 2.65 (95% CI 1.24 ~ 5.70, P <0.01). Conclusions Baseline systolic blood pressure can affect the incidence of cardiovascular and cerebrovascular events in diabetic patients. The incidence of total cardiovascular events and cerebral infarction was the lowest in systolic blood pressure 130 ~ 139 mm Hg group with diabetes mellitus.