论文部分内容阅读
目的了解天津大港油田地区成人2型糖尿病(T2DM)患者血糖达标现状,并分析其与慢性并发症、合并症的关系,为加强糖尿病防治工作提供理论依据。方法以2010年1月至2014年12月在天津市海滨人民医院内分泌科门诊就诊并行糖尿病并发症检查的2 459例患者为研究对象进行回顾性分析,记录患者的一般资料,糖化血红蛋白(Hb A1C)、尿微量白蛋白(AC)、血脂等生化指标及感觉震动阈值、眼底照相、骨密度检查结果。以Hb Al C<7%为血糖达标标准进行血糖达标率分析。结果 2 459例成人T2DM患者平均Hb A1C为7.6%±1.5%,血糖达标率为39.8%。性别、糖尿病病程、体质指数(BMI)、微血管病变、血脂异常对平均Hb A1C及血糖达标率有影响,差异均有统计学意义(P<0.05)。有糖尿病家族史,合并高血压、大血管并发症的T2DM患者与无家族史及上述合并症者相比较,血糖达标率差异无统计学意义(P>0.05)。糖尿病病程≥10年患者微血管病变、冠心病、脑血管病、高血压、骨质疏松、血脂异常、超重(或肥胖)发生率均明显高于病程<10年患者,差异均有统计学意义(P<0.05,P<0.01)。与Hb A1C未达标患者比较,Hb A1C达标的T2DM患者中,微血管病变、血脂异常、超重(或肥胖)的发生率均显著下降,差异均有统计学意义(P<0.01)。logistic回归结果显示,性别、糖尿病病程、BMI、舒张压(DBP)、糖尿病肾病(DN)、糖尿病视网膜病变(DR)、高血压、肌酐(Cr)、尿素氮(BUN)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)与血糖达标存在明显相关。结论天津大港油田地区成人T2DM患者血糖达标率较低,但已达到全国平均水平。应加强对糖尿病病程长、Hb A1C未达标的糖尿病患者的血糖控制,降低其慢性并发症、合并症的发生率。
Objective To investigate the status of glycometabolism in adults with type 2 diabetes mellitus (T2DM) in Dagang Oilfield, Tianjin, and to analyze its relationship with chronic complications and complications and to provide a theoretical basis for the prevention and treatment of diabetes mellitus. Methods From January 2010 to December 2014, 2 459 patients with complications of diabetes diagnosed in Endocrinology Clinic of Tianjin Binhai People’s Hospital were retrospectively analyzed. The general data of patients, HbA1c ), Urinary albumin (AC), blood lipid and other biochemical indicators and sensory shock threshold, fundus photography, bone density test results. Hb Al C <7% of blood glucose standards for blood glucose compliance rate analysis. Results The mean Hb A1C in 2 459 adult T2DM patients was 7.6% ± 1.5% and the blood glucose compliance rate was 39.8%. Gender, duration of diabetes, body mass index (BMI), microangiopathy and dyslipidemia had an effect on the average Hb A1C and blood glucose compliance rate (all P <0.05). T2DM patients with family history of diabetes mellitus, hypertension and macrovascular complications had no significant difference in blood glucose compliance rate (P> 0.05) compared with those without family history and the above complications. The incidence of microvascular disease, coronary heart disease, cerebrovascular disease, hypertension, osteoporosis, dyslipidemia and overweight (or obesity) in patients with diabetes over 10 years was significantly higher than that in patients <10 years of disease, with significant difference P <0.05, P <0.01). Compared with Hb A1C patients, the incidence of microvascular disease, dyslipidemia and overweight (or obesity) in Hb A1C-matched T2DM patients were significantly lower (P <0.01). The results of logistic regression showed that gender, duration of diabetes, BMI, DBP, DN, DR, hypertension, creatinine (Cr), blood urea nitrogen (BUN), triglyceride ), High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were significantly correlated with blood glucose compliance. Conclusion The blood sugar level of adult T2DM patients in Dagang Oilfield in Tianjin is relatively low, but it has reached the national average level. Should be strengthened on the long duration of diabetes, Hb A1C non-compliance of diabetic patients with glycemic control and reduce its chronic complications, the incidence of complications.