上海市大团镇557例2型糖尿病患者5年生存分析

The 5-year survival analysis of 557 type 2 diabetic patients in Datuan Town of Shanghai City

目的了解上海市大团镇2型糖尿病患者的生存状况及其影响因素,进一步指导糖尿病的防控工作。方法收集整理2008—2013年上海市大团镇2型糖尿病患者的随访资料,计算不同随访年度的生存率,用Cox回归模型分析影响患者生存的危险因素,并对不同影响因素下的死亡风险进行比较。结果调查对象随访满5年的生存率为84.2%,Cox回归分析显示影响患者生存的因素包括年龄、患病年限、活动、并发症、高血压、服药情况、糖尿病家族史和饮食状况等8项。调查对象中,参加中度活动患者的死亡风险是不太活动患者的0.182倍(P<0.001,95%CI:0.089~0.375),具有2种或以上并发症患者的死亡风险是无并发症患者的4.064倍(P=0.001,95%CI:1.768~9.342),有高血压的患者的死亡风险是无高血压患者的2.390倍(P=0.001,95%CI:1.416~4.033),规律服药患者的死亡风险是不服药患者的0.069倍(P<0.001,95%CI:0.017~0.288)。结论上海市大团镇2型糖尿病患者生存的影响因素包含多个,应根据患者的不同风险情况采取个体化的健康教育,鼓励患者适当运动、积极控制高血压和并发症、按时服药等等。

Objective To understand the survival rate and its influencing factors of type 2 diabetic patients in Datuan Town of Shanghai,and provide evidence for diabetes prevention and control work. Methods The follow-up data of type 2 diabetic patients in Datuan Town of Shanghai were collected and arrangedfrom 2008 to 2013,then the survival rates were calculatedin every follow-up year,and the survival influencing factors of patients were analyzedwith Cox regression model,the risk of death under the different influencing factors were compared. Results It was 84. 2% that the survival rate of subjects followed up for 5-year. Cox regression analysis showed that there were 8 factors affected the survival of patients,including age,years of illness,activity,complications,hypertension,medication situation,family history of diabetes and eating situation. In the study,the risk of death in patients with middling activity was 0. 182 times of less active patients( P < 0. 001,95% CI: 0. 089- 0. 375); the risk of death in patients with two or more complications was 4. 064 times of no complications patients( P = 0. 001,95% CI: 1. 768- 9. 342); the risk of death in patients with high blood pressure was 2. 390 times of no high blood pressure patients( P = 0. 001,95% CI: 1. 416- 4. 033); the risk of death in patients with regular medication was 0. 069 times of patients without medication( P < 0. 001,95% CI: 0. 017- 0. 288).Conclusion There are multiple factors affecting the survival of type 2 diabetic patients in Datuan Town of Shanghai. It should be took individualized health education depending on the patient’s risk factors,and encourage patients to do regular exercise,positive control of hypertension and complications,regular medication and so on.