脑卒中患者病耻感水平及其影响因素

目的调查脑卒中患者病耻感水平,并分析其影响因素。方法采用社会影响量表(SIS)和人口学一般资料调查表对72例脑卒中患者进行调查,并分析其影响因素。结果脑卒中患者病耻感得分为(60. 68±4. 77)分,多元逐步回归分析结果显示,自理能力、文化程度、合并慢性病是患者病耻感水平的影响因素。结论脑卒中患者病耻感处于中等水平,不同文化程度、自理能力、合并慢性病患者的病耻感水平不同,提示医务工作者及家属应针对患者的具体情况及时进行干预。     

住院2型糖尿病患者糖尿病足知识调查及相关影响因素分析

目的调查2型糖尿病患者对糖尿病足的认识情况及相关影响因素分析,提高患者对糖尿病足的认识。方法制作并发放调查问卷共计201份,收集患者的一般资料、糖尿病认识情况、糖尿病足并发症认识情况(按问题权重积分),采用logistic分析糖尿病患者对糖尿病足认识的影响因素。结果 (1)单因素分析显示是否患糖尿病足,家庭所在地,家庭年收入和文化程度与糖尿病知识得分有关,差别有统计学意义(P0.05);(2)多因素Logistic回归分析显示性别和文化程度独立影响糖尿病足知识得分。结论健康教育在糖尿病足的预防中非常关键:对于男性,文化程度低,家庭经济条件差的糖尿病患者知识更匮乏,健康教育时应付出更多的时间和耐心。     

2型糖尿病患者生命质量评价及相关因素

目的评价2型糖尿病患者生命质量现状并探讨其相关因素。方法采用欧洲五维度生命质量量表(EQ-5D)对394例2型糖尿病患者进行生命质量评价,并对影响2型糖尿病患者生命质量的相关因素进行探讨。结果 2型糖尿病患者的EQ-5D指数平均得分为(0.75±0.33)分;EQ-VAS平均得分为(64.12±16.99)分,生命质量低于普通人群。大多数2型糖尿病患者五维度测量没有困难,存在困难比例最高的维度是"疼痛/不舒服"(50.5%),其次是"行动能力"(27.9%)。单因素分析结果表明,性别、年龄、病程、文化程度、是否合并慢性病和是否采用胰岛素治疗是影响2型糖尿病患者生命质量的主要因素。多因素Logistic回归结果显示,病程、文化程度和年龄是行动能力维度的独立危险因素;文化程度是自我照顾维度的独立危险因素;文化程度和病程是日常活动维度的独立危险因素;年龄是疼痛/不舒服维度的独立危险因素;文化程度是焦虑/抑郁维度的独立危险因素。结论 2型糖尿病患者的生命质量低于普通人群。性别、年龄、病程、文化程度、是否合并慢性病和是否采用胰岛素治疗是影响2型糖尿病患者生命质量的主要因素。     

社区2型糖尿病患者糖化血红蛋白检测情况及其影响因素分析

目的调查了解本社区2型糖尿病患者糖化血红蛋白检测依从性,并分析其影响因素。方法选择2018年3—12月新泾街道社区卫生服务中心社区管理的420例2型糖尿病患者为调查对象,统计420例患者糖化血红蛋白检测频率评定其依从性,根据患者的检测依从性分为依从性组和不依从组,比较两组患者糖化血红蛋白达标率,并采用相关因素logisitic多元回归分析法分析影响患者依从性的因素。结果两组患者在年龄、文化程度、有无焦虑情绪、有无抑郁情绪、有无糖尿病病史、糖尿病认知程度、自我效能感水平高低方面的百分比比较差异有统计学意义(P0.05)。经Logistic多因素回归分析显示,合并焦虑情绪、抑郁情绪、无糖尿病家族史、对糖尿病认知程度欠佳、自我效能感欠佳是影响患者糖化血红蛋白检测依从性的主要因素。结论提高2型糖尿病患者糖化血红蛋白检测依从性能够有效控制其血糖水平稳定,焦虑抑郁情绪、疾病认知度低、自我效能感低、无糖尿病家族史等因素会影响患者的检测依从性,因此临床应加强对2型糖尿病患者的健康宣教和心理干预,纠正其对糖化血红蛋白的错误认知,以进一步提高检测依从性。     

乌鲁木齐市新市区杭州路社区老年2型糖尿病合并冠心病现状及相关危险因素

目的探讨乌鲁木齐市新市区杭州路社区老年2型糖尿病合并冠心病患者发病现状及相关危险因素分析。方法自制调查问卷调查2016年1~12月乌鲁木齐市新市区杭州路社区200例老年2型糖尿病患者冠心病患病情况,根据是否合并冠心病,应用随机数字表法将200例患者分为研究组58例(合并冠心病)和对照组142例(未合并冠心病),采用单因素和多因素Logistic回归分析老年2型糖尿病患者合并冠心病的危险因素。结果女性患者的冠心病患病率高于男性(P<0.05)。糖尿病病程超过10年的患者冠心病患病率明显高于病程≤10年者(P<0.05)。单因素分析结果显示年龄、体质量指数(BMI)、有无2型糖尿病家族史、是否吸烟、饮酒、伴有糖尿病并发症、高血压、血脂异常均与该社区老年糖尿病患者合并发生冠心病有关(P<0.05)。Logistic回归分析结果显示,吸烟、BMI≥24 kg/m~2、伴有糖尿病并发症、高血压、血脂异常是老年糖尿病患者合并发生冠心病的危险因素(P<0.05)。结论乌鲁木齐市新市区杭州路社区老年2型糖尿病患者的冠心病患病率较高,有明显的性别差异。吸烟、BMI≥24 kg/m~2、伴有糖尿病并发症、高血压、血脂异常是老年糖尿病患者合并发生冠心病的危险因素,根据相关危险因素及时制定干预措施,是降低该社区老年糖尿病患者冠心病患病率的关键。     

社区2型糖尿病患者自我效能状况及影响因素

目的 :调查社区2型糖尿病患者自我效能情况并探讨其影响因素。方法 :采用一般情况调查表、糖尿病知识调查表和自我效能量表,以方便抽样方法对2014年9—10月在社区进行糖尿病随访管理的250例2型糖尿病患者进行调查。比较不同人口学特征患者的自我效能得分情况。采用多元逐步回归和多元Logistic回归方法分析影响患者自我效能水平的因素。结果:参加调查的250例糖尿病患者中男85例(34.0%),女165例(66.0%),平均年龄(68.0±8.9)岁。患者的自我效能总分为(82.2±20.1)分,自我效能良好、中等和差的患者分别为15.6%、38.8%和45.6%。文化程度、是否在婚、月均收入、付费方式、治疗方式和既往是否参加过糖尿病自我管理与2型糖尿病患者总自我效能或某些组得分有关(均P<0.05)。多元逐步回归分析和多元Logistic回归分析结果显示,糖尿病知识知晓率、家庭人均月收入和既往是否参加过糖尿病自我管理是影响糖尿病患者总自我效能的重要因素(均P<0.05)。结论:社区2型糖尿病患者自我效能水平较低,影响因素是多方面的,应对2型糖尿病患者进行有针对性的干预,加强知识宣教、社会支持和健康教育等,提高患者的自我效能、自我管理水平和生活质量。     

2型糖尿病合并高血压患者空腹血糖控制相关因素研究

目的探讨2型糖尿病合并高血压患者空腹血糖控制的相关因素。方法选取2014年1月—2016年1月期间该院收治的2型糖尿病患者927例,其中合并高血压的患者505例,单纯2型糖尿病患者422例。采取自行设计的调查问卷对2型糖尿病合并高血压患者及2型糖尿病血压正常患者进行调查分析。结果与2型糖尿病血压正常患者相比,2型糖尿病合并高血压患者的总并发症、大血管并发症及血脂异常发生率均显著较高,空腹血糖水平显著较低,尿酸、肌酐水平显著较高,体质指数显著较高,收缩压和舒张压水平显著较高,以上各项组间比较差异有统计学意义(P0.05)。影响2型糖尿病合并高血压患者空腹血糖控制的因素主要包括地区、文化程度、家庭年均总收入、每周锻炼频次、糖尿病病程、体质指数、血压监测间隔时间、血糖监测间隔时间、血压水平、总胆固醇及甘油三酯水平等。其中地区、糖尿病病程和血压水平为2型糖尿病合并高血压患者空腹血糖控制的独立影响因素。结论在2型糖尿病合并高血压患者空腹血糖控制管理过程中,要积极加强处在农村地区的、糖尿病病程较长的、血压水平较高的患者的管理工作。     

焦作地区冠心病患者疲乏现状调查及影响因素分析

目的探讨河南省焦作地区冠心病患者的疲乏现状及其影响因素。方法选取2017年1月至2018年1月河南省焦作地区6家医院心内科收治的415例冠心病住院治疗患者作为研究对象,使用自制基本情况调查问卷及多维疲乏问卷(MFI-20)对患者的基本情况和疲乏状况进行调查。对影响冠心病患者疲乏的因素进行多元线性回归分析。结果共调查冠心病患者405例,患者平均MFI-20得分(69. 54±5. 28)分,患者普遍存在疲乏状况。单因素分析结果显示,不同性别、年龄、文化水平、治疗费用支付方式等的冠心病患者的MFI-20得分比较,差异有统计学意义(P 0. 05)。多元线性回归分析结果显示,年龄、文化程度、合并糖尿病或高血压、是否结婚、家庭人均收入、治疗费用支付方式均是影响冠心病患者疲乏的独立因素(P 0. 05)。结论冠心病患者普遍存在疲乏状况,年龄、文化程度、合并糖尿病或高血压等均是影响冠心病患者疲乏的独立因素。针对这些因素对患者进行必要的干预,对缓解患者病情,改善患者生活质量具有非常重要的意义。     

中国内地2型糖尿病合并高血压患者微量白蛋白尿检出率调查

目的调查内分泌科及心内科门诊中糖尿病合并高血压患者微量白蛋白尿（MA）检出率。方法多中心连续收集2型糖尿病合并高血压患者共2473例,采用统一调查表记录患者糖尿病、高血压控制情况及相关并发症,测量血压。采用Micral-Ⅱ试纸半定量比色法筛查尿微量白蛋白。结果2型糖尿病合并高血压患者MA的检出率为42．9％,大量白蛋白尿检出率17．0％。多因素回归分析显示,患者年龄、收缩压水平、空腹血糖水平以及BMI与糖尿病合并高血压患者MA的发生独立相关;除上述因素外,尚有糖尿病病程、应用利尿剂与大量白蛋白尿的发生独立相关。结论在2型糖尿病合并高血压患者中MA检出率极高,MA筛查及强力降压治疗甚为重要。     

农村中老年糖尿病患者自我效能现状及影响因素

目的探讨农村中老年糖尿病患者自我效能现状及其影响因素。方法应用糖尿病效能感量表(DSES)对唐山市456名农村糖尿病患者进行调查。结果唐山市农村中老年糖尿病患者总体自我效能得分为(3.61±0.82)分,其中有信心三餐固定吃与饥饿时挑选合适食物得分较高(3.96±1.68,3.72±1.21),而有信心判断异常身体状况与避免运动时低血糖的发生得分较低(3.47±1.32,3.43±1.21)。其影响因素为社会支持、糖尿病知识及是否有并发症(P<0.05)。结论唐山市农村中老年T2DM患者自我效能处于较低水平,可通过提升社会支持与糖尿病知识水平、减少并发症等途径提高自我效能水平。     

2型糖尿病患者的血糖控制和医疗费用的多因素分析

目的　了解中国大城市 2型糖尿病 (T2DM )患者的血糖 (PG)和糖化血红蛋白 (HbA1c)及其控制情况 ,以及影响患者医疗费用的因素。　方法　对国内 11个大城市的T2DM患者抽样调查 ,收集其疾病控制和治疗费用数据 ,以及相关的影响因素。调查的 1111例T2DM患者中 ,门诊 6 5 8例 ,住院 4 5 3例 ,采用描述统计的方法分析患者的HbA1c和PG控制情况 ,用多因素模型分析医疗费用的主要影响因素。　结果　 6 8%患者的空腹血糖 (FPG)没有得到很好控制 ( >7.0mmol/L) ,4 2 %的HbA1c控制效果不佳 ( >7.5 % )。门诊医疗费用的多因素分析中医院级别 (P <0 .0 0 1)、并发症 (P<0 .0 0 1)和末次空腹静脉血糖控制水平 (P <0 .0 5 )是影响患者就诊费用的主要因素。住院医疗费用多因素分析结果显示 ,住院天数 (P <0 .0 0 1)、医院级别、并发症 (P <0 .0 0 1)、家庭人均收入是影响患者住院费用的主要因素。　结论　中国大城市中 5 0 %左右T2DM患者按照 ( 2 0 0 2年的治疗情况 )PG和HbA1c控制效果不佳 ,并发症和PG控制效果不好是T2DM患者医疗费增多的显著因素     

2型糖尿病患者焦虑和抑郁现状及危险因素的研究

目的 研究T2DM患者焦虑、抑郁现状,并探讨其危险因素。 方法 采用多阶段整群随机抽样方法,采用Logistic回归分析调查473例T2DM（T2DM组）患者及473名健康对照者（NC组）焦虑、抑郁的危险因素。 结果 T2DM组焦虑和抑郁患病率分别为38.9%和31.9%,均高于NC组（16.9%和18.2%）。回归方程显示,病程（5.1～10.0年,OR=2.136）、合并抑郁（OR=3.044）和女性（OR=1.687）是T2DM患者焦虑的危险因素,家庭月收入高（≥5001元,OR=0.191）是其保护因素;年龄（61～70岁,OR=1.896）、文化水平低（小学及以下,OR=2.717）、居住方式（仅与子女居住,OR=2.532）、有并发症（OR=1.775）和焦虑（OR=3.66）是T2DM患者抑郁的危险因素。 结论 T2DM患者焦虑和抑郁患病率均高于一般人群。T2DM患者合并焦虑情绪可能与病程、家庭月收入及性别有关。T2DM患者合并抑郁可能与高龄、低文化水平、与子女居住和合并并发症有关。     

Polish Multicenter Study on Diabetes Epidemiology (PMSDE)--1998-2000

Diabetes mellitus is a growing health problem at all ages in all countries. The Saint Vincent Declaration signed by the representatives of all European countries--among them by Poland--indicated the main goals to reduce this burden. This may be achieved by elaboration and initiation of the nation-wide programme for early detection and control of diabetes on the population level. The Polish Task Force for Diabetes Management worked out and put into operation in 1998 the project commissioned by the Ministry of Health funded by the Polish State Committee for Research (PBZ-018-11). The urgent need for the implementation of this programme was a result of the increasing number of diabetic patients on the primary health care level, diabetic complications and hospitalisations. The programme was based on the assumption that primary and secondary prevention of NIDDM may eliminate or reduce its risk factors and therefore decrease its prevalence and morbidity and should integrate epidemiology, identification of risk factors, education, intervention models and economics of diabetes. This issue of the Polish Archives of Internal Medicine contains the main results of the programme and reflects an actual situation of diabetes in Poland creating a rational basis for intervention on the population level. Evaluation of the incidence rate of the diabetes type 1 in 10 selected areas (population basis 30% of age group 0-29) revealed values from 8.4 to 14.7/100,000 in the age group 1-14 and from 4.4 to 11.2/100,000 in the age group 15-29. It accounts for the 2-3 fold increase in comparison with the results achieved in 1986 (Z. Szybinski). However an ascertainment of the register in the age group 15-29 dropped down during the last 10 years and additional sources of data must be involved in the survey. Prevalence of diabetes type 2 in 3 selected areas Krakow 10.77% (M. Szurkowska), Lublin 15.6% (J. ?opatynski) and ?ód? 15.7% (J. Drzewoski) based on the population random sample over 35 years of age, constitutes over 90% of all patients with diabetes. When standardized to the Polish population the prevalence of diabetes type 2 accounts for 5.37% and reflects a true endemic state. With comparison to a similar survey carried out in 1986 in Wroc?aw the prevalence 3.71% of the diabetes type 2 increased 2-3 times. It allowed to calculate an actual number of patients with diabetes type 2--over 2 million and around 50% of them represents "unknown" diabetes. Such high contribution of the unknown non-diagnosed diabetes has been confirmed in the survey carried out in Poznań on the non-randomized professional group of persons (B. Wierusz-Wysocka) in investigation on the first-degree relatives of patients with known diabetes in Warsaw (T. Kasperska-Czyzyk) and in Wroclaw (R. Wasikowa). This raises the question about the criteria of diagnosis for unknown diabetes. Comparative analysis carried out in Krakow revealed that fasting glycemia 7.0 mmol/L allowed to diagnose diabetes with 50% with respect to the 2 hours oral glucose tolerance test (WHO 1985) and shouldn't be use as a tool for early diagnosis of diabetes type 2 (Z. Szybinski, M. Szurkowska) Identification of the risk factors in PMSDE for diabetes type 2 allowed to introduce the term "global risk factors", divided into two groups primary (obesity, age, pregnancy and genetic background) and secondary (hyperinsulinemia, hyperglycemia, dyslipidemia and hypertension). In the multifactor analysis obesity and hyperinsulinemia are the strongest predictors and modifiable risk factors of the development of diabetes type 2 and late complications. Especially hyperinsulinemia as an independent secondary risk factor for hypertension, dyslipidemia--in consequences late diabetic complications and perhaps carcinogenesis may play an important role as a predictor of diabetes type 2 and biochemical marker of effectiveness of non-pharmacological and pharmacological approach in the global concept of diabetes type 2 treatment (Z. Szybinski). Analysis of the late complications of diabetes were focussed on visual disability and lower extremity amputation due to diabetic foot development. Analysis of prevalence (PR) of visual disability due to diabetes in Krakow (J. Pantoflinski) and Olsztyn (E. Bandurska-Stankiewicz) revealed similar values, in the both areas around 6% of general visual disability in population. Monitoring of the visual disability in diabetic patients seems to be a good indicator of the quality level of the diabetic care. Analysis of the lower extremity amputation carried out in Krakow district (A. Nazim) revealed that incidence rate of amputation in diabetics was 15 times higher than in non-diabetics and in 10.8% of cases amputation was performed in unknown diabetes type 2. The preventive measures and non-pharmacological and pharmacological management approximately in diabetes should be solved with education based on the separate post of a diabetic educator within a diabetic team and on the primary health care level. The articles presenting elaborated educational model in diabetes are published in "Diabetologia Polska" (A. Czyzyk). Intervention model was tested in Krakow in the groups of obese patients with newly diagnosed "unknown" diabetes and was based on the 12 weeks supervised dietician education with standardized physical activity programme. In obese diabetic patients the weight loss less than 10% of the initial body weight can markedly improve biochemical parameters like hyperglycemia dyslipidemia and hyperinsulinemia without pharmacological therapy and 45% of patients has been transferred to the group of Impaired Glucose Tolerance (A. Gilis-Januszewska). Another model of intervention may be applied in menopausal women (J. Nadel, K. Cypryk) treated with hormonal replacement therapy as a complementary factor to education and if necessary to anti-diabetic drugs. Increase number of diabetic patients especially of the "unknown" type 2 has serious economic aspect by increasing a burden of patients, theirs families, society and health care system. Within PMSDE programme elaboration of the model for calculation the direct costs about of diabetes and burden in terms of years of life lost using DALY measure was performed (K. Kissimova-Skarbek). Average diabetes type 1 patients costs 7 times and type 2 over 3 times higher than average health care cost and 95% of total time lost due to disability is caused by diabetes type 2. Therefor primary and secondary prevention of diabetes typ 2 have highest priority among strategic preventive targets. The Review Conference held in Warsaw at 24-25 February 2001 in the presence of WHO Experts formulated the recommendations focused on: 1. Elaboration of high risk strategy for early diagnosis of unknown diabetes type 2 based on the 2-hours OGTT (WHO 1985) 2. Continuation of the epidemiologic study in diabetes 3. Instituting the professional post for diabetes educator on the specialized and primary health care levels. 4. Further research are recommended for evaluation of the role of fasting glycemia and hyperinsulinemia as predictors and risk factors of diabetes type 2, for development of preventive models in diabetes type 2 and for development of the economical models to asses the costs of diabetes (Recommendations).     

Macro- and micro-vascular complications and their determinants among people with type 2 diabetes in Bangladesh

ObjectivesTo identify the prevalence of micro- and macro-vascular complications and their associated factors for type 2 diabetes mellitus in Bangladesh.MethodsThis retrospective and cross-sectional study was conducted in six diabetes hospitals, covered urban and rural population. From April to September in 2017, a total of 1253 type 2 diabetes patients aged ≥18 years were recruited. Participants answered a pre-tested electronic questionnaire, and their medical records were reviewed for documented diabetes complications.ResultsMean age was 55.1 (±12.6) years. Among macrovascular complications, the prevalence of coronary artery disease was found to be 30.5%, 10.1% for stroke and 12.0% for diabetic foot. Among microvascular complications, nephropathy was prevalent among 34.2%, retinopathy among 25.1% and neuropathy among 5.8% of patients. Risk factors found to be associated with one or more of the complications were female gender, higher age, lower education level, an urban area of residence, higher household income, smoking, physical inactivity, hypertension, poor glycaemic control, poor adherence to treatment, longer duration of diabetes, and insulin use.ConclusionDiabetes complications are highly prevalent among type 2 diabetes population in Bangladesh. Prevention strategies should focus on increasing physical activity, weight loss, smoking cessation, and more strict control of hypertension and glycaemic level.     

Non-insulin-dependent diabetes in older patients. Complications and risk factors

Non-insulin-dependent diabetes mellitus is predominantly a disease of aging, with more than 70 percent of non-insulin-dependent (type II) diabetic patients older than 55 years of age. The prevalence of macrovascular, microvascular, and neurologic complications in outpatients with type II diabetes between the ages of 55 and 74 was compared with that in a similarly aged nondiabetic group of patients. The association between duration of diabetes, hypertension, age, and other putative risk factors that are prevalent in this elderly diabetic population and the occurrence of complications was explored. This cross-sectional survey confirmed a significant increase in retinopathy, neuropathy, impotence, and macrovascular complications in patients with type II diabetes. Within the diabetic population, duration of disease was associated with the occurrence of retinopathy and neuropathy, but not associated with such macrovascular complications as coronary artery disease. Gender, type of therapy, and previously identified risk factors for vascular disease such as hypertension had little impact on the prevalence of complications in this population. The notion that type II diabetes in the elderly represents "mild" diabetes with regard to complications must be discarded. Further identification of risk factors within this diabetic population may suggest therapeutic approaches that will prevent or ameliorate the development of complications.     

绝经后女性2型糖尿病患者骨密度与大血管并发症的相关性

目的 探讨绝经后女性2型糖尿病患者骨密度与大血管并发症的相关性.方法 对137例符合1999年世界卫生组织(WHO)糖尿病诊断标准的绝经后女性2型糖尿病住院患者,应用骨密度仪测定骨密度和T值,根据有无大血管并发症分2组,比较骨密度和T值.应用多因素非条件Logistic回归分析骨质疏松与大血管并发症的相关性.结果 绝经后女性2型糖尿病合并大血管并发症组的骨密度、T值显著低于不伴有大血管并发症组(P＜0.01～0.05),调整了年龄、血压、血脂、体重指数、糖尿病病程、绝经时间后,经多因素非条件Logistic回归分析显示骨质疏松与大血管并发症仍存在显著的相关性(OR=4.473,95%CI:1.770～11.300).结论 绝经后女性2型糖尿病患者骨密度的降低可能与大血管并发症的发生、发展有关.     

老年2型糖尿病病人血清糖类抗原19-9水平及其相关影响因素分析

目的本研究旨在探讨老年T2DM病人血清糖类抗原19-9(CA19-9)的水平及其影响因素。方法选择2019年3~10月在我院内分泌科住院的536例老年T2DM病人,检测其CA19-9及糖脂代谢相关指标水平,并记录病人使用的降糖药物和微血管并发症发生情况。比较不同CA19-9水平病人的临床特征。采用Spearman相关分析和多元逐步回归分析评价CA19-9水平的影响因素。结果老年T2DM病人CA19-9水平升高的发生率为7.5%。CA19-9<37 U/mL组和CA19-9≥37 U/mL组间LDL-C、HbA1c、血钙、餐后2 h C肽水平差异有统计学意义(P<0.05或0.01)。使用双胍类药物的病人的CA19-9水平低于使用非双胍类药物的病人(P<0.01)。Spearman相关分析结果显示,CA19-9与年龄、TC、TG、CRP、HbA1c呈正相关(P<0.05),与血清白蛋白及餐后2 h C肽呈负相关(P<0.05)。多元逐步回归分析结果显示,HbA1c是CA19-9的独立影响因素。结论使用二甲双胍的老年T2DM病人可能具有较低水平的CA19-9。老年T2DM病人的CA19-9水平与血糖控制效果密切相关。     

中老年患者心血管病危险因素与冠状动脉病变程度的相关性分析

目的 探讨心血管病危险因素与冠状动脉(冠脉)病变严重程度的相关性. 方法入选2008年10月至2009年12月在山东大学齐鲁医院行冠脉造影术的病例728例,收集其性别、年龄、吸烟史、高血压、糖尿病、总胆红素(TBIL)、血脂、尿酸等临床资料.同时收集患者冠脉造影结果,以美国心脏病学会和美国心脏协会(ACC/AHA)评分法计算冠脉病变积分,以冠脉病变积分及是否诊断为冠心病评价其冠状动脉病变程度.统计学处理采用多因素回归分析. 结果多因素回归分析结果显示,男性、年龄、高血压、糖尿病,高密度脂蛋白胆固醇这5个危险因素是影响冠脉病变积分主要的危险因素,也是冠心病的主要危险因素;其中糖尿病是冠脉病变程度最重要的可控危险因素(OR=3.1179 P=0.005).相关分析显示低密度脂蛋白胆固醇、体质指数、总胆固醇、三酰甘油、尿酸、TBIL与冠脉病变程度存在相关性,但并未进入回归方程,在本研究中并为冠脉病变程度主要影响因素. 结论男性、年龄、高血压、糖尿病、低高密度脂蛋白胆固醇是冠脉病变严重程度的主要危险因素,且对于血脂水平较低的中国人有更好的预测价值.

Abstract：

Objective To evaluate the correlation between multiple cardiovascular risk factors and severity of coronary heart disease (CHD) in patients undergoing coronary angiography. Methods Seven hundred and twenty eight patients who underwent coronary angiography were selected from Qilu Hospital from October 2008 to December 2009. The clinical data about cardiovascular risk factors including age, gender, hypertension, smoking status, type 2 diabetes mellitus, dyslipidemia, high uric acid level, low total bilirubin level, and coronary angiography results were collected. The severity and extent of coronary stenosis was evaluated by ACC/AHA coronary scoring system and CHD was diagnosed by angiography. Analyses were achieved by multiple regression analysis. Results Multiple regression analysis showed that age, gender, hypertension, type 2 diabetes mellitus and low HDL-C were prominent predictors of severity and extent of coronary heart disease. DM was the primary controllable risk factor of CHD (OR=3. 1179, P=0. 005). Conclusions The age, gender,hypertension, type 2 diabetes mellitus and low HDL-C are correlated with angiographic severity and extent of CHD. Consequently, controlling these five risk factors is important in the intervention and prevention of CHD.     

南宁社区2型糖尿病患者合并高血压的影响因素分析

目的分析南宁社区2型糖尿病患者合并高血压的影响因素。方法于2017-05~2017-07采用多阶段随机抽样方法抽取南宁城市地区(青秀区)和农村地区(横县)2型糖尿病患者496例,其中城市地区299例,农村地区197例。采用问卷调查和体格检查的方式收集患者信息,应用二分类logistic回归分析探讨影响2型糖尿病患者发生高血压的因素。结果本研究共检出糖尿病合并高血压患者293例(59.07%)。二分类logistic回归分析结果显示,较高的文化水平(OR=0.501,95%CI:0.286~0.876)和参加体育锻炼(OR=0.652,95%CI:0.426~0.999)是抑制2型糖尿病患者发生高血压的保护因素,而有饮酒习惯(OR=2.156,95%CI:1.219~3.811)和较大的腰围(OR=1.038,95%CI:1.016~1.060)是促进2型糖尿病患者发生高血压的危险因素。结论2型糖尿病患者中高血压的患病率较高,在糖尿病管理中应更多地关注患者饮酒行为和腰围的控制,以便更好地控制糖尿病患者的血压,提高患者生命质量。     

Patients with type 2 diabetes aged 35-64 years at four primary health care centres in Stockholm County, Sweden. Prevalence and complications in relation to gender and socio-economic status

This study estimates the prevalence of known diabetes, and complications of type 2 diabetes, among subjects aged 35-64 years, in relation to socio-economic factors and gender at four primary health care centres (PHCCs) in Stockholm County, Sweden. A total of 685 diabetic subjects aged 35-64 years of age were identified in primary care by diagnosis using electronic patient records. Data were supplied from medical records, and postal questionnaires. The prevalence of known diabetes among subjects aged 35-65 years differed between the PHCCs, with standardised rates between 1.7 and 3.6%, with the highest figure at the PHCC in an underprivileged area. The prevalence was higher among men (2.8% versus 1.7%). A subgroup of the patients, i.e. 389 subjects aged 35-64 years with type 2 diabetes, was studied with regard to complications. Higher education level was protective for microvascular complications (OR 0.50; CI 0.25-1.00). In addition, microvascular complications were predicted by male sex, duration, HbA(1c), and hypertension, and macrovascular complications by male sex, age, and hypertension. Prevalence of known diabetes and microvascular complications in type 2 diabetes, are associated with lower socio-economic status and male sex.