东北地区军队离退休干部2型糖尿病心血管疾病风险控制现状调查

Investigation of controling the risk factors of cardiovascular disease among retired army cadres with T2DM in northeast China

目的了解东北地区军队医疗保健管理下离退休干部2型糖尿病(T2DM)的血糖、血脂、血压综合控制达标情况。方法对东北地区患T2DM的军队离退休干部及其配偶以问卷形式进行调查。共纳入477例T2DM患者,按照是否合并心血管疾病(CVD)分为合并CVD组(n=350)和未合并CVD组(n=127),比较两组患者的糖化血红蛋白(HbA1c)、空腹血糖、餐后2h血糖、血压、血脂控制水平和达标率。结果 477例T2DM患者总体HbA1c(<7%)达标率为65.8%,其中非CVD组的达标率(74.8%)高于CVD组(56.9%),差异有统计学意义(χ2=13.857,P<0.05)。总体LDL-C(<2.6mmol/L)达标率为47.8%,非CVD组达标(<2.6mmol/L)率(47.2%)高于CVD组达标(<1.8mmol/L)率(23.9%),差异有统计学意义(χ2=20.93,P<0.05)。总体血压(<140/80mmHg)达标率为85.5%,CVD组(85.1%)和非CVD组(86.4%),差异无统计学意义(χ2=0.155,P>0.05)。总体血糖、血压、血脂综合达标率为23.5%,非CVD组(25.1%)与CVD组(22.9%)比较差异无统计学意义(χ2=0.284,P>0.05)。结论东北地区军队医疗保健管理下T2DM离退休干部的血糖、血脂、血压控制单因素达标率和综合达标率均高于国内普通人群,达到甚至高于国外糖尿病患者的调查水平。合并与不合并心血管疾病者的综合达标率无明显差异。

Objective To investigate the integrated control levels of hemoglobin A1c （HbA1c）, systolic and diastolic blood pressure （BP）, low-density lipoprotein cholesterol （LDL-C） in retired army cadres suffering from type 2 diabetes （T2DM） in northeast China. Methods Four hundred and seventy-seven retired army cadres （aged ≥ 50 years） with T2DM were interviewed using questionnaire. The subjects were assigned into two groups according to the presence （n=350） or without （n=127） cardiovascular disease （CVD）, and then the control levels of HbA_1c, fast blood glucose （FBG）, 2-hour postprandial blood glucose （2hPG）, BP, blood cholesterol （TC）, triglycide （TG）, high-density lipoprotein cholesterol （HDL-C） and LDL-C were compared between the two groups. Results The overall successful rate of control of HbA_1c （〈7%） was 65.8%. The overall successful rate of controling HbAI, in diabetic patients without CVD was significantly higher than in those with CVD （74.8% vs 56.9%, χ2=13.857, P〈0.05）. The overall successful rate for controling LDL-C in enrolled subjects （〈2.6mmol/L） was 47.8%. The overall successful rate for controling LDL-C in patients without CVD （〈2.6mmol/L） was significantly higher than in those with CVD （〈 1.8mmol/L） （47.2% vs 23.9%, χ2=6.77, P〈0.05）. In 85.5% of patients the target of controling blood pressure （〈 140/80mmHg） was achieved. The successful rates were almost identical between the with- and without-CVD groups （85.1% vs 86.4%, χ2=0155, P〉0.05）. The comprehensive attainment rate for controling HbA_1c, BP and LDL-C among all the subjects was 23.5%, and no significant difference was found between with- and without-CVD subjects （22.9% vs 25.1%, χ2=0.284, P〉0.05）. Conclusions Under the military health care management system, the unique and comprehensive successful rate for controling HbA_1c, BP and LDL-C was higher among retired army cadres in northeast China as compared with that in non-military Chinese populations, and it is close to, even higher than the reported levels abroad. The successful rate shows no difference between with- or without-CVD subjects.