唐山地区2型糖尿病患者血压控制与住院总费用的相关性分析

Correlation analysis of blood pressure control and total hospitalization cost in patients with type 2 diabetes mellitus in Tangshan area

目的探讨2型糖尿病(T2DM)患者血压控制对住院总费用的影响。方法选取2020年6月至2021年1月唐山市工人医院内分泌科收治住院的T2DM患者277例。按住院总费用的四分位数将入组患者分为Q1~Q4组。采用多因素logistic回归模型分析高血压、收缩压、舒张压分别与T2DM患者住院总费用水平(Q1~Q4)的关联;并在模型中加入乘积交互项,分别检验相关协变量与高血压有无交互作用。采用广义线性回归模型分析高血压、收缩压、舒张压分别与T2DM患者住院总费用的关联。结果在T2DM患者中,与非高血压患者相比,高血压患者住院总费用增加的风险显著升高(OR 2.13,95%CI:1.29~3.51);空腹静脉血糖(FPG)水平与高血压对T2DM患者住院总费用存在交互作用(P_(交互)=0.03);T2DM患者收缩压、舒张压每增加1 mmHg(1 mmHg=0.133 kPa),住院总费用分别增加22.61元、59.02元。结论针对T2DM患者,需要定期随访患者的血糖、血压水平,并对导致患者住院总费用增加的危险因素进行早期筛查,对潜在的健康问题采取预防性措施并制定个性化诊疗方案,从而减轻疾病治疗及生产力损失给患者带来的经济负担。

ObjectiveTo investigate the influence of blood pressure control on total hospitalization cost in T2DM.MethodsA total of 277 patients with T2DM admitted to the Endocrinology Department of Tangshan Worker′s Hospital from June 2020 to January 2021 were selected.Patients were divided into Q1-Q4 groups according to the quartile of total hospitalization expenses.Multivariate Logistic regression model was used to analyze the relationship between hypertension,systolic blood pressure(SBP),diastolic blood pressure(DBP),and the level of total hospitalization expenses(Q1-Q4)of patients with T2DM.We add product interaction terms to the model and test whether there is any interaction between the relevant covariates and hypertension.A generalized linear regression model was used to analyze the relationship between hypertension,SBP,and DBP and the total hospitalization expenses of T2DM patients.ResultsAmong patients with T2DM,patients with hypertension had a significantly increased risk of increased total hospital costs compared with those without hypertension(OR 2.13,95%CI:1.29-3.51).There is an interaction between FPG level and hypertension on the total hospitalization cost of T2DM patients(P_(interaction)=0.03).For each increase of SBP and DBP of T2DM patients by 1 mmHg,the total hospitalization cost increased by 22.61 yuan and 59.02 yuan,respectively.ConclusionFor T2DM patients,we need to regularly follow up on their blood glucose and blood pressure levels,and conduct early screening of risk factors that increase the total hospitalization cost.We should take preventive measures for potential health problems and develop personalized diagnosis and treatment plans to reduce the economic burden of disease treatment and productivity losses on patients.