论文部分内容阅读
2型糖尿病患者是心血管病的高危人群,这一事实已众所周知,一些重要的循证医学证据明确显示2型糖尿病患者发生冠心病(CHD)的危险性是非糖尿病者的3-4倍。2.型糖尿病患者心血管病的死亡率至少是普通人群的3倍以上,单纯糖尿病患者在10年内发生心肌梗死或冠脉死亡的危险性与陈旧性心肌梗死患者相当,且糖尿病患者发生急性心肌梗死的预后远较非糖尿病患者差。此外Lasko等对313例2型糖尿病进行的7年随访研究发现,高密度脂蛋白胆固醇(HDL-C)减低、极低密度脂蛋白胆固醇(VLDC—C)以及甘油三酯(TG)增高,是2型糖尿病发生CHD的独立危险因素。Lamarche等发现。空腹胰岛素,载脂蛋白β(APOB)和小而致密的LDL(sLDL)水平亦是2型糖尿病发生CHD的重要危险因素。还有研究发现载脂蛋白C3(APOC3)升高具有明显的致动脉粥样硬化的作用,其水平的升高往往预示CHD事件的危险性增加。美国胆固醇教育计划(NCEP)成人治疗组第三次指南(ATPⅢ)中.明确将糖尿病视为冠心病的等危症,并主张对糖尿病患者进行积极降脂冶疗。中国的患者也存在着多种危险因素,有统计显示在住院的糖尿病患者中,诊断明确的CHD患病率为35.3%。中国糖尿病管理合作组先后于1998年、2001年和2003年3次参加亚洲多国家、多中心资料分析,结果显示大多数糖尿病患者未获
The fact that type 2 diabetes is a high-risk group of people with cardiovascular disease is well known and some important evidence-based medical evidence clearly shows that patients with type 2 diabetes have a 3-4 times greater risk of developing coronary heart disease (CHD) than nondiabetic patients. Cardiovascular mortality in patients with type 2 diabetes is at least 3 times higher than in the general population. Patients with simple diabetes have a 10-year risk of myocardial infarction or coronary artery death comparable to those of patients with old myocardial infarction, and acute myocardial infarction in patients with diabetes The prognosis of infarction is far worse than non-diabetic patients. In addition, Lasko and other 7-year follow-up study of 313 cases of type 2 diabetes found that high density lipoprotein cholesterol (HDL-C) decreased, very low density lipoprotein cholesterol (VLDC-C) and triglyceride Independent risk factors for CHD in type 2 diabetes mellitus. Lamarche and other discovery. Fasting insulin, apolipoprotein β (APOB), and small but dense LDL (sLDL) levels are also important risk factors for CHD in type 2 diabetes. There are also studies have found that elevated apolipoprotein C3 (APOC3) has a significant role in the development of atherosclerosis, its elevated levels are often indicative of an increased risk of CHD events. In the Third Handbook of the American Cholesterol Education Program (NCEP) Adult Treatment Group, ATP III clearly identifies diabetes as an equal risk of coronary heart disease and advocates aggressive lipid-lowering therapy in patients with diabetes. There are also a number of risk factors for patients in China. Statistics show that the prevalence of diagnosed CHD among hospitalized diabetic patients is 35.3%. China Diabetes Management Cooperation Group participated in the multi-country and multicentre data analysis in Asia three times in 1998, 2001 and 2003 respectively. The results showed that the majority of diabetic patients were not