天津市2型糖尿病慢性并发症流行病学研究

Epidemiological study on chronic complications of type 2 diabetes mellitus in Tianjin

目的分析天津市2型糖尿病患者慢性并发症流行病学资料,做好疾病预防诊断及治疗工作。方法选取2016年9月至2017年12月天津市糖尿病第一鉴定中心对天津市2型糖尿病患者的调查问卷,主要包含糖尿病并发症情况、患者糖化血红蛋白、糖耐量及胰岛功能检测结果等。该研究共收集药物治疗2型糖尿病患者622例,注射胰岛素治疗2型糖尿病者658例。比较血糖情况、糖化血红蛋白、糖耐量、胰岛功能、糖尿病慢性并发症流行病学资料等指标。结果622例药物治疗组糖化血红蛋白平均值为7.98%,658例胰岛素治疗组糖化血红蛋白平均值为7.22%,两组糖化血红蛋白差异有统计学意义(P<0.05)。有视网膜病变者与无病变者糖化血红蛋白水平分别为9.33%、7.97%,差异有统计学意义(F=6.859,P=0.010)。有神经病变者与无病变者糖化血红蛋白水平分别为7.23%、8.18%,差异有统计学意义(F=6.334,P=0.012)。有糖尿病心肌病变者与无病变者糖化血红蛋白水平分别为8.30%、7.52%,差异有统计学意义(F=6.666,P=0.010)。有周围血管病病变者与无病变者糖化血红蛋白水平分别为9.25%、7.91%,差异有统计学意义(F=5.377,P=0.001)。有糖尿病肾病者与无病变者糖化血红蛋白水平分别为9.27%、7.92%,差异有统计学意义(F=5.831,P=0.001)。结论天津市糖尿病患者年龄及病程、血糖控制情况等与糖尿病慢性并发症的发生率呈正比关系,病程越长、糖尿病患者年龄越大,并发症的发生率就越大,糖化血红蛋白控制达标对于延缓糖尿病视网膜病变、糖尿病周围血管病变、糖尿病性心肌病、糖尿病肾病更有利。及早、规范化控制血糖及糖化血红蛋白,保护胰岛功能,对糖尿病并发症的防治有重要意义。

Objective To analyze the epidemiological data of chronic complications in the patients with type 2 diabetes mellitus(T2DM)in Tianjin City for doing a good job in disease prevention,diagnosis and treatment.Methods The questionnaires on the patients with T2DM in Tianjin City in the Tianjin Municipal First Identification Center for Diabetes from September 2016 to December 2017 were selected,mainly including the diabetic complications,results of glycosylated hemoglobin,glucose tolerance and pancreas islet function test,etc.A total of 622 cases of T2DM and 658 cases of T2DM treated by insulin injection were collected.Blood glucose,glycosylated hemoglobin,glucose tolerance,pancreas islet function,epidemiological data of diabetes mellitus chronic complications were compared.Results The average glycosylated hemoglobin value in 622 cases of the medication treatment group was 7.98%,which in 658 cases of the insulin treatment group was 7.22%,there was statistically significant difference between the two groups(P<0.05).The glycosylated hemoglobin levels in the patients with retinopathy and those without retinopathy were 9.33%and 7.97%respectively,the difference was statistically significant(F=6.859,P=0.010).The glycosylated hemoglobin levels in the patients with neuropathy and those without neuropathy were 7.23%and 8.18%respectively,the difference was statistically significant(F=6.334,P=0.012).The glycosylated hemoglobin levels in the patients with diabetic cardiomyopathy and those without diabetic cardiomyopathy were 8.30%and 7.52%,respectively,the difference was statistically significant(F=6.666,P=0.010).The glycosylated hemoglobin levels in the patients with peripheral vascular disease and those without peripheral vascular disease were 9.25%and 7.91%,respectively,the difference was statistically significant(F=5.377,P=0.001).The glycosylated hemoglobin levels in the patients with diabetic nephropathy and those without diabetic nephropathy were 9.27%and 7.92%respectively,the difference was statistically significant(F=5.831,P=0.001).Conclusion The age,disease course and blood glucose control condition in the diabetic patients in Tianjin City are positively correlated to the incidence rate of diabetic chronic complications.The longer the disease course and the older the diabetic patients,the greater the complications occurrence rate.Glycosylated hemoglobin control reaching the standard is benificial for delaying diabetic retinopathy,diabetic peripheral vascular disease,diabetic cardiomyopathy and diabetic nephropathy.Normalized controlling blood glucose and glycosylated hemoglobin as early as possible,and protecting the function of pancreatic islets have great significance to the prevention and treatment of diabetic complications.