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[新诊断的II型糖尿病患者5年期间的冠心病及相关危险因素]

[Coronary heart diseases and associated risk factors in newly manifested type II diabetic patients over the course of 5 years].

作者信息

Schmechel H, Schulze J, Hanefeld M, Lippold C, Schwanebeck U, Rössger G, Haller H

机构信息

Kliniken-Polikliniken, Weimar.

出版信息

Z Gesamte Inn Med. 1989 Mar 15;44(6):172-5.

PMID:2728558
Abstract

Using the baseline data of the diabetes intervention study (DIS) from 1126 newly manifested type II-diabetics our analysis demonstrates higher mean-values of some components of the so-called metabolic syndrome in patients with ECG-abnormalities indicating coronary heart disease (CHD) in diagnosis of diabetes compared with subjects without ECG-findings. The impact of general risk factors for the prevalence of CHD in diagnosis and after a 5-year follow-up is obviously different in both sexes. In multivariate analysis only systolic blood pressure was persistently a significant predictor in both sex groups. With increasing age life-duration gets as time-related factor importance for the development of CHD. The mathematically demonstrated association of triglyceride levels to the presence of ECG-abnormalities agrees with the results of WHO multinational study of vascular disease in diabetes mellitus. In the interventions as well as in the control-groups diabetic subjects with CHD after 5 year follow-up showed in comparison to diabetics without CHD higher levels of investigated risk factors which develop their pathogenetic effect probably by their clustering impact, because the differences of their mean-values are only in some cases significant. The common lower level of the most risk factors at the intervention group compared with the conventionally treated group is the result of the intervention measures.

摘要

利用1126例新诊断的II型糖尿病患者的糖尿病干预研究(DIS)基线数据,我们的分析表明,在糖尿病诊断中,心电图异常提示冠心病(CHD)的患者中,所谓代谢综合征的某些成分的平均值高于无心电图异常的受试者。在诊断时和5年随访后,冠心病患病率的一般危险因素对两性的影响明显不同。在多变量分析中,只有收缩压在两个性别组中始终是一个显著的预测因素。随着年龄的增长,寿命作为与时间相关的因素对冠心病的发生发展具有重要意义。数学证明的甘油三酯水平与心电图异常之间的关联与世界卫生组织糖尿病血管疾病多国研究的结果一致。在干预组和对照组中,5年随访后患有冠心病的糖尿病患者与无冠心病的糖尿病患者相比,所研究的危险因素水平更高,这些危险因素可能通过其聚集作用产生致病效应,因为它们平均值的差异仅在某些情况下具有显著性。与传统治疗组相比,干预组大多数危险因素的普遍较低水平是干预措施的结果。

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