天津大港油田地区成人2型糖尿病患者血糖达标现状分析

Analysis of blood glucose control situation in patients with type 2 diabetes mellitus of Tianjin Dagang Oil-field

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 study the blood glucose control situation in patients with type 2 diabetes mellitus of Tianjin Dagang Oilfield area and to analyze the relationship between blood glucose level and chronic complications. Methods From January 2010 to December 2014, 2 459 outpatients with diabetes mellitus（DM） served as the subjects. The data of general information, Hb A1 C,urine trace albumin（AC）, blood lipid, electric diagram, vascular doppler, fundus photography and bone mineral density were collected. Hb A1C 〈7% was served as blood glucose control standard. The blood glucose control rate was analyzed. Results Average Hb A1 Clevel of 2 459 T2 DM patients was 7.6%±1.5%, the blood glucose control rate was 39.8%. The gender, duration of diabetes,BMI, microvascular disease and dyslipidemia could influence the blood glucose control rate（P〈0.05）. There was no significant difference of blood glucose control rate between T2 DM patients with family history of T2 DM, hypertension or macrovascular complications and T2 DM patients without family history of T2 DM, hypertension or macrovascular complications（P〉0.05）. The morbidities of microvascular disease, coronary heart disease, cerebrovascular disease, dyslipidemia and overweight（or obesity） in patients with diabetes duration≥10 years were significantly higher than those in in patients with diabetes duration〈10 years（P〉0.05,P〉0.01）. The morbidities of microvascular disease, dyslipidemia and overweight（or obesity） in patients with Hb A1C 〈7% were significantly lower than those in in patients with Hb A1C≥ 7%（P〉0.01）. Logistic regression analysis showed that the gender, duration of diabetes, BMI, DBP, DN, DR, hypertension, Cr, BUN, TG,HDL-C and LDL-C may be associated with the blood glucose control rate. Conclusion The blood glucose control rate of adult patients with type 2 DM in Tianjin Dagang oil-field area was lower than average national level. The blood glucose levels of T2 DM patients with longer diabetes duration and low Hb A1 Ccontrol rate should be controlled to reduce the morbidities of chronic complications.