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2型糖尿病合并冠心病患者的心脏康复:一项对比研究。

Cardiac rehabilitation in patients with type 2 diabetes mellitus and coronary disease: a comparative study.

作者信息

Toste Sofia, Viamonte Sofia, Barreira Ana, Fernandes Preza, Lopes Gomes José, Torres Severo

机构信息

Serviço de Fisiatria, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.

Serviço de Cardiologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto, Portugal.

出版信息

Rev Port Cardiol. 2014 Oct;33(10):599-608. doi: 10.1016/j.repc.2014.01.026. Epub 2014 Oct 11.

Abstract

INTRODUCTION AND AIMS

Diabetic patients have a 2-4 times higher risk of cardiovascular disease than non-diabetic individuals. The aims of this study are to evaluate the effects of a cardiac rehabilitation program (phase II) in patients with diabetes and coronary disease and to compare the results with regard to control of cardiovascular risk factors and improvement in functional capacity with coronary patients without diabetes.

METHODS

This was a prospective study of patients diagnosed with ischemic heart disease referred for a cardiac rehabilitation program between January 2009 and June 2013. The population was divided into two groups: diabetic and non-diabetic. Patients were assessed at the beginning of phase II and three months later and the following parameters were recorded: body mass index, waist circumference, lipid profile, blood glucose and glycated hemoglobin in diabetic patients, blood pressure, smoking, physical activity level (using the International Physical Activity Questionnaire) and functional capacity (on treadmill stress testing).

RESULTS

The study population consisted of 682 patients (253 diabetic and 429 non-diabetic). Diabetic patients were significantly older, had a worse cardiovascular risk profile (higher prevalence of overweight, dyslipidemia, hypertension and sedentary lifestyle) and lower functional capacity. At the end of phase II, there was a statistically significant improvement (p<0.05) in all risk factors and functional capacity, which was similar in both groups, except for body mass index, triglycerides and functional capacity.

CONCLUSIONS

Diabetic patients may benefit from a cardiac rehabilitation program and achieve comparable results to non-diabetic patients.

摘要

引言与目的

糖尿病患者患心血管疾病的风险是非糖尿病个体的2至4倍。本研究的目的是评估心脏康复计划(第二阶段)对糖尿病合并冠心病患者的影响,并将心血管危险因素控制及功能能力改善方面的结果与非糖尿病冠心病患者进行比较。

方法

这是一项对2009年1月至2013年6月间被转诊至心脏康复计划的缺血性心脏病患者的前瞻性研究。研究人群分为两组:糖尿病组和非糖尿病组。在第二阶段开始时及三个月后对患者进行评估,并记录以下参数:体重指数、腰围、血脂谱、糖尿病患者的血糖和糖化血红蛋白、血压、吸烟情况、身体活动水平(使用国际身体活动问卷)以及功能能力(通过跑步机压力测试)。

结果

研究人群包括682名患者(253名糖尿病患者和429名非糖尿病患者)。糖尿病患者年龄显著更大,心血管风险状况更差(超重、血脂异常、高血压和久坐生活方式的患病率更高)且功能能力更低。在第二阶段结束时,所有危险因素和功能能力均有统计学显著改善(p<0.05),两组情况相似,但体重指数、甘油三酯和功能能力除外。

结论

糖尿病患者可能从心脏康复计划中获益,并取得与非糖尿病患者相当的结果。

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