2型糖尿病和糖尿病足综合征患者主要心血管危险因素的控制

I.I. Teltevskaia, S. V. Ivanova, E. Yushchuk, A. Mkrtumyan, I. V. Melehina, E. Trush
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摘要

心血管疾病(CVD)是糖尿病(DM)患者死亡的主要原因。2型糖尿病患者的心血管风险高出2 - 4倍,心血管疾病的发生时间比非糖尿病患者早15年。及时发现并有效控制危险因素对预防2型糖尿病并发症具有决定性意义。本研究的目的是:确定2型糖尿病合并糖尿病足综合征(DFS)患者的心血管危险因素并分析其控制效果。材料和方法。80例2型糖尿病患者无相关心血管疾病。平均年龄64.6±9.2岁。2型糖尿病病程为10.0 (4.0;15.0)年。进行了临床检查、实验室(临床和生化血液检查)和仪器(心电图、头臂动脉和下肢动脉超声、超声心动图、容积血压计)研究。结果。高血压检出率为98.8%,血脂异常检出率为91.0%。血压(BP)目标值为32.0%,低密度脂蛋白胆固醇(LDL-C)目标值为26.0%。80.0%的患者接受降压治疗,39.7%的患者接受降脂治疗。二甲双胍是2型糖尿病药物治疗结构中最常用的口服降糖药。DFS患者使用胰岛素的频率明显更高。55.0%的患者糖化血红蛋白(HbA1c)达到目标水平。DFS患者的收缩压和脉压明显升高,达到目标血压的次数减少了3倍。结论。2型糖尿病患者的特点是血糖和主要心血管危险因素控制不够有效。因此,每2例患者记录目标HbA1c水平,每3例患者记录目标BP水平,每4例患者仅记录LDL-C目标值。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Control of Major Cardiovascular Risk Factors in Patients with Type 2 Diabetes and Diabetic Foot Syndrome
Cardiovascular disease (CVD) is the main cause of death in patients with diabetes mellitus (DM). Cardiovascular risk in patients with type 2 diabetes is 2–4 times higher, and CVD occurs 15 years earlier than in people without diabetes. Timely detection and effective control of risk factors are of decisive importance for the prevention of complications of type 2 diabetes. The aim of the study: to identify cardiovascular risk factors and analyze the effectiveness of their control in patients with type 2 DM and diabetic foot syndrome (DFS). Material and methods. 80 patients with type 2 diabetes without associated CVD. Mean age 64.6 ± 9.2 years. The duration of type 2 diabetes was 10.0 (4.0; 15.0) years. Conducted a clinical examination, laboratory (clinical and biochemical blood tests) and instrumental (electrocardiography, ultrasound of the brachiocephalic arteries and arteries of the lower extremities, echocardiography, volumetric sphygmography) studies. Results. The frequency of detection of hypertension was 98.8%, dyslipidemia 91.0%. Target values of blood pressure (BP) were noted in 32.0%, and target values of low-density lipoprotein cholesterol (LDL-C) in 26.0% of the examined. 80.0% of patients received antihypertensive therapy, and 39.7% of patients received lipid-lowering therapy. Metformin was the most commonly prescribed oral hypoglycemic drug in the structure of drug therapy for type 2 diabetes. Insulin was significantly more frequently prescribed to patients with DFS. The target level of glycated hemoglobin (HbA1c) was observed in 55.0% of patients. Patients with DFS had significantly higher systolic and pulse BP, and reached the target BP values three times less often. Conclusion. Patients with type 2 diabetes are characterized by insufficiently effective control of glycemia and major cardiovascular risk factors. Thus, the target HbA1c levels were noted in every second patient, the target BP level in every third patient, and the target values of LDL-C only in every fourth patient.
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