| Objective:To analyze the effect of HbAlc control on the prognosis of chronic heart failure in patients with chronic heart failure(CHF)combined with type 2 diabetes(T2DM).Methods:We were collected patients with were underwent CHF or CHFcombined with T2DM,who were admitted to the Nanping First Hospital Affiliated to Fujian Medical University,From January 1,2013 to December 31,2016.To collect their gender,age,smoking history,ventricular rate(HR),systolic pressure,diastolic blood pressure,pulse,N-terminal B-type natriuretic peptide(NT-ProBNP),C-reactive protein(CRP),troponin Ⅰ(cTnI),creatinine,hemoglobin,left ventricular ejection fraction(LVEF),medications and other related indicators prior to admission..According to the admission HbAlc levels,all patients,who were underwent CHF and T2DM,were divided into four groups:A group CHF with T2DM and HbAlc ≤ 6.2%;B group CHF with T2DM and 6.2%<HbA1c ≤ 7.0%;C group CHF with T2DM and 7.0%<HbAlc ≤8.0%;D group CHF with T2DM and HbAlc>8.0%;Retrospective observational studies were performed on the four groups and were followed up until December 31,2017.The control group was a group of patients with CHF alone.The prognostic indexes of patients with CHF combined with T2DM were evaluated by taking the standard rate of nt-probnp at discharge,LVEF value,cardiac function classification after treatment,average length of stay and re-admission rate within 1 year.With LVEF high on admission,discharge plasma NT-Pro BNP levels drop 30%or more,heart function at discharge class Ⅰ-Ⅱ,less average hospitalization days,1 year low readmission rate as CHF combined T2DM patients prognosis is good standard..Result:1.The plasma NT-Pro BNP levels were significantly different between groups A and B and C(P<0.05).There was no significant difference between B and C groups(P>0.05).There was a significant difference between group C and group D(P<0.05).There was no significant difference between group A and group D(P<0.05).After treatment,the NT-ProBNP reached the standard rate in each group,group B(63.49%),group C(64.52%)>group A(48.28%),group D(34.33%).2.At the time of admission,each group was compared with LVEF values:there was a statistically significant difference between group A and group B and group C(P<0.05);there was no significant difference between group B and group C(P>0.05),and the difference between group B and group C was significant.Compared with group D,the difference was statistically significant(P<0.05).There was no significant difference between group A and group D(P<0.05).3.Comparative analysis of cardiac function of patients admitted to hospital and discharged:Cardiac function of group A,group B,group C,and group D were compared on admission:There was a statistically significant difference between group A and group B and group C(P<0.05);There was no significant difference between group C and group C(P>0.05).There was significant difference between group B and C and D(P<0.05).There was no significant difference between group A and D(P<0.05).).At admission,cardiac function IV(31.0%in group A and 37.31%in group D)was higher in group A and group D than in groups B and C(19.05%in group B and 17.74%in group C).After active treatment during hospitalization,B The recovery of heart function in both groups was significantly better than that in groups A and D(48.83%in group A,65.12%in group B,66.13%in group C,and 42.55%in group D).The average number of hospital days in each group was compared to 10.79±2.23 days in group A,8.95 ± 2.37 days in group B,9.26±1.95 days in group C,and 10.98±2.23 days in group D.Combined with the average number of days of hospital admission,it can be concluded that the average number of hospital days in the A and D groups is greater than the average length of stay in the B and D groups.Within one year,various readmission rates in group D(63.8%)>group A(55.2%)>group B(53.5%)>group C(51.6%).We compared the CRP between the groups and found no statistical difference(P>0.05).Conclusion:In patients with CHF and T2DM,our retrospective observational studies have shown that HbAlc is associated with patient prognosis,with moderate blood glucose control(6.2%<HbAlc ≤ 8.0%)and a better prognosis. |
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