2型糖尿病合并心房颤动的危险因素分析

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摘要目的研究2型糖尿病（T2DM）发生心房颤动（AF）的危险因素。方法选择2016年1月～2018年1月于徐州医科大学附属医院就诊的T2DM患者530例（对照组），T2DM合并AF患者533例（T2DM合并AF组），并将533例T2DM合并AF患者分为2个亚组，包括合并阵发性心房颤动患者220例（T2DM合并PAF组）与合并非阵发性心房颤动患者313例（T2DM合并NPAF组）。收集其相关指标进行单因素方差分析、Logistic回归分析，筛选出影响因素，并用受试者工作特征曲线（ROC）分析其预测价值。结果单因素分析显示，对照组与T2DM合并AF组的尿酸、血糖、糖化血红蛋白、胆红素、低密度脂蛋白及胆固醇水平差异有统计学意义（P ＜ 0.05）；Logistic回归分析显示尿酸（OR = 1.005，P ＜ 0.05）、糖化血红蛋白（OR = 1.398，P ＜ 0.05）是T2DM发生AF的危险因素；总胆红素（OR = 0.929，P ＜ 0.05）、低密度脂蛋白（OR = 0.285，P ＜ 0.05）及胆固醇（OR = 0.610，P ＜ 0.05）是T2DM患者发生AF的保护因素；ROC曲线分析提示上述指标对房颤发生均有一定的预测价值。结论在T2DM患者中，尿酸及糖化血红蛋白是房颤发生的独立危险因素；而总胆红素、低密度脂蛋白及胆固醇是发生房颤的保护性因素。

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	邱娜凌宏威周冬梅孙娟应长江李伟

关键词 ：糖尿病, 房颤, 尿酸, 糖化血红蛋白, 血脂

Abstract：Objective To investigate the risk factors of atrial fibrillation (AF) in type 2 diabetes mellitus (T2DM). Methods From January 2016 to January 2018, 530 cases of T2DM patients (control group), 533 patients with T2DM combined with AF (T2DM combined with AF group) admitted to the Affiliated Hospital of Xuzhou Medical University were selected, 533 patients with T2DM combined with AF were divided into two subgroups, including 220 patients with paroxysmal AF (T2DM combined with PAF group) and 313 patients with non-paroxysmal AF (T2DM combined with NPAF group). Relevant indicators were collected for univariate anova and Logistic regression analysis, influencing factors were screened out, and their predictive value was analyzed by ROC. Results Univariate analysis showed that there were statistically significant differences in the levels of uric acid, blood glucose, glycosylated hemoglobin, bilirubin, low-density lipoprotein and cholesterol between the control group and T2DM combined with AF group (P ＜ 0.05). Logistic regression analysis showed that uric acid (OR = 1.005, P ＜ 0.05) and glycosylated hemoglobin (OR = 1.398, P ＜ 0.05) were risk factors for the occurrence of AF in T2DM. Total bilirubin (OR = 0.929, P ＜ 0.05), low-density lipoprotein (OR = 0.285, P ＜ 0.05) and cholesterol (OR = 0.610, P ＜ 0.05) were protective factors for the occurrence of AF in T2DM patients. ROC curve analysis showed that the above indicators have certain predictive value for the occurrence of atrial fibrillatione. Conclusion Uric acid and glycosylated hemoglobin are independent risk factors for atrial fibrillation in patients with T2DM, while total bilirubin, low-density lipoprotein and cholesterol are the protective factors of atrial fibrillation.

Key words： Diabetes Atrial fibrillation Uric acid Glycosylated hemoglobin Serum lipid

基金资助:国家自然科学基金资助项目（81701298）；
江苏省徐州市科技项目（KC17194）。

通讯作者: 李伟（1957.11-），男，教授，硕士生导师，徐州医科大学附属医院内分泌科主任医师，江苏省内分泌分会副主任委员，徐州市内分泌分会主任委员；研究方向：糖尿病病因，糖尿病慢性并发症的发病机制及干预。

作者简介: 邱娜（1994.12-），女，徐州医科大学2016级内分泌与代谢病专业在读硕士研究生；研究方向：糖尿病及其并发症。

引用本文:

邱娜凌宏威周冬梅孙娟应长江李伟. 2型糖尿病合并心房颤动的危险因素分析[J]. 中国医药导报, 2019, 16(11): 105-108.
QIU Na LING Hongwei ZHOU Dongmei SUN Juan YING Changjiang LI Wei. Risk factors for type 2 diabetes mellitus with atrial fibrillation. 中国医药导报, 2019, 16(11): 105-108.

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http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2019/V16/I11/105

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