基于社区2型糖尿病患者5年内首发心脑血管事件构建风险预测模型
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摘要
目的:构建社区2型糖尿病患者5年内首次发生心脑血管事件的风险预测模型。方法:选取社区内未发生过心脑血管事件的2型糖尿病患者323例作为研究对象,所有样本均来自深圳市社区健康服务信息系统中明月社区健康服务中心在管的糖尿病专案患者,且都有完整的糖尿病相关随访资料。记录心脑血管事件发生例数,同时比较研究对象队列中患心脑血管疾病与未患心脑血管疾病的相关变量如年龄、血压等,并对变量进行弗明翰评分。结果:随访期间研究对象共发生38例心脑血管事件,发病密度为11. 76%。模型主要变量包括年龄、性别、收缩压、低密度脂蛋白、高密度脂蛋白和心脑血管病家族史。发生心脑血管疾病的患者年龄、总胆固醇、收缩压、低密度脂蛋白水平以及心脑血管疾病家族史率均明显高于未患心脑血管疾病者,而高密度脂蛋白水平则低于未患心脑血管疾病者。结论:研究建立的2型糖尿病患者心脑血管事件预测模型可以为社区糖尿病患者治疗和预后提供帮助,同时可以预防糖尿病并发心脑血管疾病。
Objective To construct a risk prediction model of first occurrence of cardiovascular events in community type 2diabetes patients within 5 years. Method A total of 323 patients with type 2 diabetes who did not have CVD events in our community were enrolled in this study. All samples came from the Shenzhen community health service information system in the Mingyue community health service center in diabetes patients,with complete diabetes-related follow-up data. The number of CVD events was recorded. At the same time,the related variables such as age,blood pressure and other factors in patients with CVD diseases and those not in the study cohort were compared,and the variables were compared to the Framingham score. Results A total of 38 CVD events occurred during the follow-up period,with an incidence of 11. 76%. The main variables of the model include age,sex,systolic blood pressure,low density lipoprotein,high density lipoprotein,and family history of CVD diseases. Age,total cholesterol,systolic blood pressure,low density lipoprotein,and rate family history with CVD diseases in patients with CVD diseases were significantly higher than those without,while HDL levels were lower. Conclusion the prediction model of cardiovascular events in patients with type 2 diabetes built in the study can help the treatment and prognosis of patients in community. At the same time,it can prevent diabetes and CVD.
Objective To construct a risk prediction model of first occurrence of cardiovascular events in community type 2diabetes patients within 5 years. Method A total of 323 patients with type 2 diabetes who did not have CVD events in our community were enrolled in this study. All samples came from the Shenzhen community health service information system in the Mingyue community health service center in diabetes patients,with complete diabetes-related follow-up data. The number of CVD events was recorded. At the same time,the related variables such as age,blood pressure and other factors in patients with CVD diseases and those not in the study cohort were compared,and the variables were compared to the Framingham score. Results A total of 38 CVD events occurred during the follow-up period,with an incidence of 11. 76%. The main variables of the model include age,sex,systolic blood pressure,low density lipoprotein,high density lipoprotein,and family history of CVD diseases. Age,total cholesterol,systolic blood pressure,low density lipoprotein,and rate family history with CVD diseases in patients with CVD diseases were significantly higher than those without,while HDL levels were lower. Conclusion the prediction model of cardiovascular events in patients with type 2 diabetes built in the study can help the treatment and prognosis of patients in community. At the same time,it can prevent diabetes and CVD.
引文
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[9]张丽敏,王庆开,叶苗苗,等. 2型糖尿病炎症因子水平与心脑血管病变的相关性[J].中国老年学杂志,2013,33(5):10.
[2]贾伟平.糖尿病慢性并发症的适宜筛查技术[J].中华内科杂志,2014,53(8):649.
[3]燕娟,郭巍伟,梁执群,等. 2型糖尿病大鼠模型的建立及其验证[J].临床和实验医学杂志,2009,8(4):10.
[4]张晶,金雪娥. 2型糖尿病患病风险预测的研究进展[J].中华实用诊断与治疗杂志,2013,27(9):33.
[5]文江平,田亚平. 2型糖尿病高危人群筛查研究进展[J].国际检验医学杂志,2015,36(18):2711.
[6]侯玉梅,朱亚楠,朱立春,等.决策树模型在2型糖尿病患病风险预测中的应用[J].中国卫生统计,2016,33(6):143.
[7]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2013年版)[J].中华糖尿病杂志,2014,14(7):447.
[8]林倍倍,陈博武,吴柏霆,等.上海市社区居民糖尿病并发症及相关因素调查研究[J].中国预防医学杂志,2017,18(4):249.
[9]张丽敏,王庆开,叶苗苗,等. 2型糖尿病炎症因子水平与心脑血管病变的相关性[J].中国老年学杂志,2013,33(5):10.