150例老年糖尿病并发症临床总结分析

Clinical Analysis of Complication of Senile Diabetic:a Report of 150 Cases

目的探讨老年糖尿病并发症与年龄、病程、糖化血红蛋白(HbA1c)、低密度脂蛋白胆固醇(LDL-C)、肥胖的关系。方法对150例老年糖尿病患者各系统并发症的发病情况进行统计,根据年龄、病程及血糖控制情况(HbA1c)、血脂(LDL-C)水平、肥胖(BMI≥28 kg/m2)这5项指标进行分组对照分析。结果 150例老年糖尿病患者中,同时存在3种及以上并发症者78例,占52%;心血管疾病发生率最高,高血压病72例,占48%,冠心病62例,占41.3%;高血压、冠心病、脑出血情况在HbA1c>7.5%、高LDL-C、肥胖中有较高患病率;糖尿病肾病、周围神经病变、视网膜病变、糖尿病足在HbA1c>7.5%、病程>10年中有较高患病率;周围神经病变和脑梗塞在年龄≥80岁中发病率偏高。结论老年糖尿病并发症与血糖控制好坏、血脂、体重密切相关,与病程、年龄有一定相关性,应尽早识别和积极控制血糖、血脂,提高患者生存质量,延缓并发症的发生。

Objective To investigate the relationship between the complications and the age, course of disease, glycosylated hemoglobin（ HbA1 c） ,low density lipoprotein cholesterol （LDL-C） and fat in aged patients with diabetes mellitus. Methods A group comparison analysis was performed on incidence of complications in 150 cases of aged diabetic. Patients were divided into different groups by the indicatorsof age sector, course of disease, blood sugar control situation（ HbA1 c ） , blood fat level （ LDL-C ） and obesity（BMI〉~28 kg/m2）. Results Among the 150 patients,there were 78 cases（52% ） with 3 or more complications. The incidence rate of cardiovascular disease was the highest,72 cases（48% ） were with hypertension,62 cases（41.3% ） with coro- nary disease. The incidence rate of hypertension, coronary heart disease and cerebral hemorrhage was higher in cases with HbA1 c more than 7.5 % , high LDL-C and obesity. The incidence rate of diabetic nephropathy, peripheral neuropathy, retinopathy, diabetic feet was higher in cases with HbA1C more 7.5% and course of diabetes over 10 years. The incidence rate of peripheral neuropa- thy and cerebral infarctiori was higher in cases with age over 80 years old. Conclusion Aged patients with diabetes mellitus has very close relation with blood sugar control, blood fat level and weight, also has certain extent relation with course of disease and age, so early diagnosis and prompt treatment to control blood sugar and blood fat are suggested so that living quality could be im- proved and incidence of complication could be lowered as well.