2型糖尿病患者伴慢性肾脏病和外周动脉疾病对全因死亡和心血管疾病死亡的影响

Effects of chronic kidney disease and peripheral arterial disease on all-cause and cardiovascular disease mortality in type 2 diabetes patients

关键词:  2型糖尿病  慢性肾脏病  外周动脉疾病  踝臂指数

Key words:  type 2 diabetes mellitus  chronic kidney disease  peripheral arterial disease  ankle-brachial index

摘要:

目的 评价2型糖尿病（type 2 diabetes mellitus, T2DM）患者伴慢性肾脏病(chronic kidney disease, CKD)和外周动脉疾病(peripheral arterial disease, PAD)对全因和心血管疾病（cardiovascular disease, CVD）死亡的影响。方法 2004年7月—2005年1月，收集北京和上海地区8所医院的T2DM患者1559例。根据是否患有CKD或PAD，将研究对象分为不同的CKD/PAD组，对其进行5年的随访研究。使用生存分析比较各组的生存率，使用COX比例风险模型比较各组的全因和CVD死亡相对危险度（relative risk, RR）。结果 经过5年随访，共获得1343例T2DM患者的完整随访资料。随访期间，共发生全因死亡370例（27.55%），其中CVD死亡185例（13.78%）。与非PAD非CKD组相比较，CKD合并PAD组的全因和CVD死亡率最高，其RR值分别为3.12（95%CI: 2.30~4.24）和3.47（95%CI: 2.29~5.24）。结论 T2DM患者同时伴CKD和PAD具有较高的全因和CVD死亡风险。

Abstract:

Objective To evaluate the effect of chronic kidney disease(CKD) and peripheral arterial disease(PAD) on all-cause and CVD mortality in patients with type 2 diabetes mellitus(T2DM). Methods A total of 1559 T2DM patients were recruited from eight hospitals in Beijing and Shanghai from July 2004 to January 2005. Patients were categorized into different CKD/PAD groups, according to their CKD and PAD status. Survival rates among different CKD/PAD groups were compared after a 5-year follow up. Cox regression model was used to compare relative risk(RR) of death from all-cause and CVD. Results In total,1343 T2DM patients completed the 5-year follow-up. The number of all-cause and CVD deaths was 370(27.55%) and 185(13.78%), respectively. Compared with the group of no CKD and PAD, patients in the CKD and PAD group had the higher all-cause and CVD mortality(RR: 3.12,95%CI: 2.30-4.24;RR: 3.47,95%CI: 2.29-5.24). Conclusion T2DM patients with combined CKD and PAD have a high risk of all-cause and CVD mortality.