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糖尿病对充血性心力衰竭患者生活质量的影响。

Impact of diabetes mellitus on quality of life in patients with congestive heart failure.

机构信息

Clinic of Internal Medicine I, Friedrich-Schiller-University, Erlanger Allee 101, 07747 Jena, Germany.

出版信息

Qual Life Res. 2012 Sep;21(7):1171-6. doi: 10.1007/s11136-011-0039-9. Epub 2011 Oct 16.

Abstract

OBJECTIVES

Congestive heart failure (CHF) and diabetes mellitus (DM) are increasing in prevalence. There are conflicting data regarding the crosstalk of DM and CHF with respect to the prognostic impact for the patients. Health-related quality of life (Hr-QoL) has been reported to be useful for risk stratification. The purpose of this study was to investigate the impact of DM on Hr-QoL in a CHF population.

METHODS

325 consecutive patients with CHF were retrospectively analyzed (age 49 ± 12 years, 74.2% male, 18% had diabetes). After a median follow-up time of 7.4 years, we compared Hr-QoL of patients with and without DM. Hr-QoL was assessed using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Kaplan-Meier curves were used to compare survival.

RESULTS

The presence of DM reduced Hr-QoL in patients with CHF, indicated by a higher overall MLHFQ score (43.5 vs. 21, P = 0.013). Kaplan-Meier survival curves showed a significant survival difference (P = 0.024). Survival rates of both groups differed significantly after 3 (P = 0.031), 5 (P = 0.006), and 10 years (P = 0.047) favoring the group without DM.

CONCLUSIONS

In patients with CHF, the coexistence of DM is associated with a reduced Hr-QoL and a particularly poor long-term survival. Our results indicate that CHF patients with DM are at increased risk.

摘要

目的

充血性心力衰竭(CHF)和糖尿病(DM)的患病率正在上升。关于 DM 和 CHF 之间的相互作用对患者预后的影响,存在相互矛盾的数据。健康相关生活质量(Hr-QoL)已被报道可用于风险分层。本研究旨在探讨 DM 对 CHF 患者 Hr-QoL 的影响。

方法

回顾性分析了 325 例连续 CHF 患者(年龄 49 ± 12 岁,74.2%为男性,18%患有糖尿病)。中位随访时间为 7.4 年后,我们比较了有和无 DM 的患者的 Hr-QoL。使用明尼苏达州心力衰竭生活质量问卷(MLHFQ)评估 Hr-QoL。Kaplan-Meier 曲线用于比较生存。

结果

DM 的存在降低了 CHF 患者的 Hr-QoL,表现为总体 MLHFQ 评分较高(43.5 对 21,P = 0.013)。Kaplan-Meier 生存曲线显示生存差异有统计学意义(P = 0.024)。两组的生存率在 3 年(P = 0.031)、5 年(P = 0.006)和 10 年(P = 0.047)后有显著差异,无 DM 组的生存率更高。

结论

在 CHF 患者中,DM 的共存与 Hr-QoL 降低和长期预后不良密切相关。我们的研究结果表明,DM 合并 CHF 的患者风险增加。

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