社区2型糖尿病患者尿白蛋白肌酐比值控制现状及影响因素分析

Analysis of the control status of urinary albumin-creatinine ratio and the influencing factors in patients with type 2 diabetes in the community

目的:分析社区2型糖尿病患者尿白蛋白肌酐比值(UACR)控制现况及其影响因素。方法:整群抽取2018-2019年参加社区卫生服务中心糖尿病并发症筛查项目的1005例2型糖尿病患者,其中男性431例(42.89%),女性574例(57.11%);平均年龄(66.98±9.86)岁。对患者开展基本情况调查、常规体格检查和实验室检测,分析患者UACR控制现况。以UACR<30 g/mg为正常组,UACR≥30 g/mg为异常组,探讨影响UACR控制的因素。结果:1005例社区2型糖尿病患者的UACR达标率为63.98%;糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-c)和高密度脂蛋白胆固醇的达标率分别为31.54%、86.47%、84.58%、82.19%和63.08%。两组患者的性别、病程、体重指数、高血压、HbA1c、TG的差异有统计学意义(P<0.05);Spearman和Peason相关性分析结果显示,性别(女性)、病程、高血压、HbA1c、TG与UACR呈正相关(P<0.05);Logistic回归分析结果显示,病程、高血压、HbA1c、TG水平是影响UACR水平的因素(P<0.05)。结论:UACR水平与社区2型糖尿病患者的病程、高血压、HbA1c、TG相关,提示应重视患者UACR控制情况,加强对血糖、血压和血脂的控制,预防糖尿病肾病的发生。

Objective:To analyze the control status of urinary albumin-creatinine ratio(UACR)and the influencing factors in patients with type 2 diabetes in the community.Methods:A total of 1005 patients with type 2 diabetes who participated in the screening program of diabetes complications in the community health service center from 2018 to 2019 were selected by cluster sampling,among them,there were 431 males(42.89%)and 574 females(57.11%);the average age was(66.98±9.86)years.The basic condition investigation,routine physical examination and laboratory test were carried out to analyze the current situation of UACR control.UACR<30 g/mg was taken as the normal group,and UACR≥30 g/mg as the abnormal group to explore the factors affecting UACR control.Results:The UACR compliance rate of 1005 patients with type 2 diabetes in the community was 63.98%;the compliance rates of glycosylated hemoglobin(HbA1c),total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-c)and high-density lipoprotein cholesterol were 31.54%,86.47%,84.58%,82.19%and 63.08%,respectively.There were significant differences in gender,course of disease,body mass index,hypertension,HbA1c and TG between the two groups(P<0.05);the results of the correlation analysis between Spearman and Peason showed that gender(female),course of disease,hypertension,HbA1c,TG and UACR were positively correlated(P<0.05);logistic regression analysis showed that the course of disease,hypertension,HbA1c,and TG levels were factors that affected UACR levels(P<0.05).Conclusion:The level of UACR is related to the course of disease,hypertension,HbA1c and TG of patients with type 2 diabetes in the community,which suggests that attention should be paid to the control of UACR,and strengthening the control of blood glucose,blood pressure and blood lipid to prevent the occurrence of diabetic nephropathy.