蚌埠地区168例糖代谢异常患者25年转归分析

Outcomes of 168 patients in Bengbu 25 years after being screened out with abnormal glycometabolism

目的:了解蚌埠地区1980年糖尿病(DM)普查出的168例糖代谢异常患者(144例T2DM、24例IGT)25年临床转归。方法:根据患者病情不同,对144例T2DM和24例IGT患者分别给予生活方式及药物干预,25年间对114例T2DM患者及22例IGT各项临床指标进行随访。结果:114例T2DM中4例患者逆转为IGT;心脑血管、肾病/视网膜病变患病率分别为57.0%、60.5%;25年病死率为70.2%(80/114)。主要死亡原因依次为心脑血管病、多脏器功能衰竭、慢性肾功能不全、恶性肿瘤。24例IGT患者失访2例,18.2%发展成DM,年转变率为0.73%,36.4%仍为IGT,45.5%转为NGT。结论:T2DM慢性并发症以大血管和微血管病变患病率最高,且随病程延长增加;综合干预可有效降低IGT向DM转化。

Objective To explore the clinical outcomes of 168 patients with abnormal glycometabolism （ 144 cases with type 2 diabetes mellitus and 24 cases with impaired glucose tolerance （IGT）] in Bengbu, who were screened out in 1980. Method All 168 patients received lifestyle-intervention or medication, and were followed-up for 25 years. Results In 144 patients with diabetic mellitus, there were 4 cases reverted to IGT, the prevalence rate of cardiovascular and cerebrovascular diseases and nephropathy/retinopathy were 57.0% and 60.5%, respectively. 25-year mortality rate was 70.2% （80/114）, and the major causes in order were cardiovascular and cerebrovascular diseases, chronic multiorgan dysfunction, chronic renal dysfunction, and malignant tumours. In 22 cases of IGT （2 cases lost）, 18.2% were developed to diabetic mellitus, annual turnover rate was 0.73%, 36.4% remained IGT, and 45.5% reverted to normal glucose tolerance. Conclusion Macro and micro vascular lesion are the most common chronic complications in type 2 diabetes, and the prevalence rate is increased with course develops. Combined intervention can effectively decrease the rate of IGT develop to DM.