浙江省临海市农村糖尿病人群周围神经病变患病率及影响因素分析

Analysis of morbidity and risk factors of diabetic peripheral neuropathy in rural areas of Linhai city in Zhejiang Province

目的了解浙江省临海市农村社区糖尿病人群糖尿病周围神经病变（DPN）的患病率及其相关因素,为农村地区DPN的有效防治提供参考依据。方法对2010-2013年临海市38个农村社区建档的糖尿病慢性病管理人群进行DPN筛查,共完成筛查621例,男性247例,女性374例,年龄31-89岁,平均（60.5±11.4）岁。DPN采用多伦多临床评分系统（TCSS）进行诊断。根据有无DPN分为DPN组（212例）与非DPN组（409例）进行分析,并进一步对DPN有关的影响因素进行二元logistic回归分析。结果临海市农村社区糖尿病人群中DPN患病率为34.14%;两组年龄、糖尿病病程、高血压史、腰围、体质指数、收缩压、肌酐、尿酸、甘油三酯和总胆固醇比较,差异均有统计学意义（P〈0.01）;logistic回归分析显示,年龄、糖尿病病程、高血压、腰围、体质指数和尿酸是与DPN相关的独立危险因素（P〈0.01）。结论长期良好控制血糖、血压及多项代谢异常可能对DPN的防治具有重要意义。

Objective To understand the morbidity and risk factors of diabetes peripheral neuropathy（DPN） in rural areas of Linhai in Zhejiang and to provide the base for preventing DPN. Methods The managed diabetic patients in 38 rural communities of Linhai were screened for DPN during 2010-2013,621 hyperglycemic subjects were investigated, 247 males and 374 females, 31-89 years old, average age：（60.5 ±11.4） years old. DPN was diagnosed according to the Toronto Clinical Scoring System（TCSS）. The subjects were divided into DPN group（212 cases） and non-DPN group（409 cases）. The potential risk factors associated with DPN were analyzed by stepwise binary logistic regression analysis. Results The morbidity of DPN in the diabetic patients in 38 rural communities of Linhai was 34.14%. There were significant differences of age, diabetes duration, history of hypertension, waistline, body mass index（BMI）, systolic blood pressure（SBP）, creatinine, uric acid（UA）, triglyceride（TG） and total cholesterol（TC） between two groups（P〈0.01）. Binary logistic regression analysis showed that age, diabetes duration,hypertension, waistline, BMI and UA were the independent risk factors for DPN（P〈0.01）. Conclusion The controlling of plasma glucose, blood pressure and metabolic disorder may be important for preventing DPN.