长沙市成人糖尿病治疗和控制现状及影响因素分析

Analysis of adult diabetes treatment and control and influencing factors among adult diabetes patients in Changsha city

目的了解长沙市成人糖尿病治疗及控制现状及其影响因素,为制定糖尿病防控措施提供依据。方法采用多阶段整群随机抽样方法,以长沙市18岁及以上19 580名居民为研究对象,进行问卷调查、体格检查和空腹血糖测定。用SPSS 21.0进行统计学分析,计数资料的比较用χ2检验,用多因素非条件logistic回归分析糖尿病治疗率和控制率的影响因素。结果长沙市成人糖尿病患者治疗率为55.43%,城市(58.21%)高于农村(52.28%);年龄越大,糖尿病治疗率越高;同时患糖尿病和高血压的人群糖尿病治疗率(60.51%)高于仅患糖尿病的人群(47.85%);知晓自身患病者的治疗率较高(86.80%);锻炼频率越高的患者治疗率越高,差异均有统计学意义(P<0.01)。长沙市成人糖尿病控制率为34.87%,年龄越大、文化程度越高、锻炼频率越高的糖尿病患者控制率越高,居住在城市(39.50%)、同时患高血压者(36.61%)、知晓患病者(53.97%)、实施治疗者(51.56%)的血糖控制率分别高于居住在农村(29.61%)、未患高血压者(28.48%)、不知晓患病者(1.12%)、未实施治疗者(14.12%),差异均有统计学意义(P<0.01)。多因素logistic回归分析结果显示,城市(OR=2.23,95%CI:1.47~3.37)、年龄大(OR=1.88,95%CI:1.44~2.46)、知晓患病(OR=4 281.91,95%CI:592.50~30 944.95)是糖尿病治疗的影响因素;文化程度(OR=1.19,95%CI:1.00~1.40)、知晓患病(OR=427.26,95%CI:129.63~1 408.22)、药物治疗(OR=0.48,95%CI:0.32~0.70)是糖尿病控制的影响因素。结论长沙市糖尿病患者的治疗率、控制率均较低,应加强糖尿病治疗和控制血糖对健康的重要性的宣传教育。

Objective To understand the diabetes treatment and control and influencing factors among adults in Changsha city and to provide the basis for preventing and controlling diabetes. Methods The multistage random sampling method was used to select 19 580 residents （〉18 years old） as the subjects. The investigation was performed with the questionnaires, physical examinations and fasting blood glucose tests. The data were compared with χ^2 test, and the influencing factors of preventing and controlling diabetes were analyzed with the unconditional multivariate logistic regression method. The used software was SPSS 21.0. Results The treatment rate of adult diabetes in Changsha was 55.43 %, the urban treatment rate （58.21%） of diabetes was significantly higher than the rural treatment rate （52.28%） （P〈0.01）; the treatment rate of diabetes increased with age; the treatment rate of diabetes patients with hypertension was 60.51% which was significantly higher than that （47.85%） of diabetes patients without hypertension （P〈0.01）; the treatment rate of diabetes patients with awareness was higher （86.80%）; the treatment rate of diabetes patients increased with frequent exercise （P〈0.01）. The control rate of adult diabetes in Changsha city was 34.87%, and increased with age, education level and exercise frequency. The blood glucose control rates in urban diabetes patients, diabetes patients with hypertension, diabetes patients with awareness and diabetes patients with treatment were 39.50%, 36.61%, 53.97% and 51.56%, respectively, which were significantly higher than rural diabetes control rate （29.61%）, diabetes control rate （28.48%） of patients without hypertension, diabetes control rate （I. 12%） of patients without awareness and diabetes control rate （14.12%） of patients without treatment （P〈0.01）. The results of multivariate logistic regression analysis indicated that urban area （OR=2.23, 95%CI： 1.47-3.37）, age （OR=1.88, 95%CI： 1.44-2.46）, awareness （OR=4 281.91, 95%CI： 592.50-30 944.95） were the influencing factors of diabetes treatment; the education level （OR=1.19, 95%CI： 1.00-1.40）, the illness awareness （OR=427.26, 95%CI： 129.63-1 408.22） and medication therapy （OR =0.48, 95% CI： 0.32-0.70） were influencing factors of the diabetes control. Conclusion The diabetes treatment and control rates in Changsha are lower. The importance of publicity and education for diabetes treatment and blood glucose control on health should be strengthened.