冠心病合并2型糖尿病患者心血管残余风险的识别与管理研究进展
Research Progress on Identification and Management of Residual Cardiovascular Risk in Patients with Coronary Heart Disease and Type 2 Diabetes
DOI: 10.12677/acm.2026.1662319, PDF,   
作者: 麦麦提托合提·萨迪克：新疆维吾尔自治区和田地区墨玉县人民医院心血管内科，新疆 和田；新疆医科大学第一临床医学院，新疆 乌鲁木齐；图尔迪麦麦提·阿卜杜麦麦提*：新疆医科大学第一临床医学院，新疆 乌鲁木齐；新疆维吾尔自治区和田地区墨玉县人民医院呼吸与危重症医学科，新疆 和田
关键词: 冠心病；2型糖尿病；心血管残余风险；综合管理；精准干预；Coronary Heart Disease； Type 2 Diabetes； Residual Cardiovascular Risk； Comprehensive Management； Precision Intervention
摘要: 冠心病合并2型糖尿病患者即使接受规范的二级预防治疗，仍存在较高的心血管事件复发风险，提示心血管残余风险广泛存在。其形成机制复杂，主要涉及脂质代谢紊乱、慢性低度炎症、血糖及代谢异常、血栓前状态以及心肾功能损害等多个维度。近年来，大量循证医学证据表明，除强化降低低密度脂蛋白胆固醇外，针对高甘油三酯血症、炎症激活、促栓状态及心肾代谢异常进行个体化干预，可进一步改善患者预后。本文围绕冠心病合并2型糖尿病患者心血管残余风险的概念、主要构成、病理生理机制及干预策略进行综述，并结合特殊临床情境总结综合管理要点，以期为该类患者的精准治疗提供参考。
Abstract: Patients with coronary heart disease complicated by type 2 diabetes remain at a high risk of recurrent cardiovascular events even after standard secondary prevention, indicating that substantial residual cardiovascular risk persists. The mechanisms are complex and mainly involve lipid metabolic disorders, chronic low-grade inflammation, glycemic and metabolic abnormalities, a prothrombotic state, and cardiac-renal dysfunction. Recent evidence suggests that, in addition to intensive lowering of low-density lipoprotein cholesterol, individualized interventions targeting hypertriglyceridemia, inflammatory activation, prothrombotic status, and cardiorenal-metabolic abnormalities may further improve prognosis. This review summarizes the concept, major components, pathophysiological mechanisms, and intervention strategies of residual cardiovascular risk in patients with coronary heart disease and type 2 diabetes, and discusses comprehensive management in special clinical settings, aiming to provide a reference for precision treatment.
文章引用：麦麦提托合提·萨迪克, 图尔迪麦麦提·阿卜杜麦麦提. 冠心病合并2型糖尿病患者心血管残余风险的识别与管理研究进展[J]. 临床医学进展, 2026, 16(6): 1128-1136. https://doi.org/10.12677/acm.2026.1662319

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