糖尿病患者发生慢性并发症的危险因素分析

Study on the Risk Factors of Diabetic Chronic Complications

目的分析糖尿病患者发生慢性并发症的危险因素。方法问卷调查糖尿病患者的基本情况,采用体格测量与生化实验室相结合的方法。根据是否发生慢性并发症进行分组,统计两组不同体质指数(BMI)、腰围、血脂等各项指标,并通过Logistic回归分析发生慢性并发症的风险因素。结果本次调查合格问卷共2 626例,发生慢性并发症的糖尿病患者1 790例(68.2%),其中主要包括心脑血管并发症(高血压1 262例占48.1%,冠心病1 514例占57.7%,脑梗死1 521例占57.9%),视网膜病变1 336例(50.9%)、神经病变1 189例(45.3%)、糖尿病病足1 729例(65.8%)。Logistic回归分析结果显示,家族史、病史时长、BMI、年龄是糖尿病合并心脑血管病变的危险因素(P<0.05或P<0.01),病史时长是糖尿病合并神经病变及视网膜病变的危险因素(P<0.01),劳动强度、病史时长是糖尿病合并糖尿病足患者的危险因素(P<0.01)。结论糖尿病患者年龄越大、BMI越高,存在家族糖尿病史且病史时间越长,发生慢性并发症的风险越高,早发现、早诊断、早治疗、控制体质量有助于降低慢性并发症发生风险。

Objective To estimate the risk factors of diabetic chronic complications. Methods The basic information was investigated with a self-designed questionnaire and the combination of physical measurement and biochemical laboratory method was adopted. According to the occurrence of the chronic complications, the patients were divided into two groups, and the different indexes including body-mass index （BMI）, waist circumference and blood lipid of the two groups were recorded. Logistic regression model was used to analyze the risk factors of diabetic chronic complications. Results Altogether 2 626 cases of complete data were selected. The incidence of diabetic chronic complications was 68.2% ： hypertension 1 262 cases（48.1% ） ,coronary heart disease 1 514 cases（57.7% ） ,cerebral infarction 1 521 cases（57.9% ） ,diabetic ret- inopathy 1 336 cases（50.9% ） ,diabetic neuropathy 1 189 cases（45.3% ） ,diabetic foot 1 729 cases（65.8% ）. The family history, long disease course, age and BMI were risk factors of cardiovascular disease complicating diabetes （P 〈 0.05 or P 〈 0.01 ）. The long disease course was the risk factor of diabetic neuropathy and retinopathy（ both P 〈 0.01 ）. The intensity of labor and the long course were risk factors of the diabetic foot （P 〈 0.01 ）. Conclusion Higher age, BMI, the long course of diabetes and family history would increase the risk of diabetic chronic complications. Early detection, early diagnosis, early treatment and weight control could reduce the risk of chronic complications.