住院老年2型糖尿病患者微血管病变的相关因素分析

目的探讨老年2型糖尿病患者微血管病变的构成比及相关因素。方法用回顾性分析的方法研究2003年～2010年于卫生部北京医院住院治疗的年龄≥60岁的2型糖尿病患者876例,分为糖尿病肾病(DN)组和非糖尿病肾病(非DN)组,糖尿病视网膜病变(DR)组和非糖尿病视网膜病变(非DR)组,糖尿病周围神经病变(DPN)组和非糖尿病周围神经病变(非DPN)组,计算DN、DR、DPN构成比,比较患者的临床特点,并探寻老年2型糖尿病患者DR、DN、DPN的相关因素。结果 (1)DN构成比为34.5%,DR构成比为42.4%,DPN构成比为82.3%。(2)DN与非DN两组间体质量指数(BMI)、糖尿病病程、高血压病程、收缩压(SBP)、舒张压(DBP)、空腹血糖(FBS)、糖化血红蛋白(HbA1c)、空腹胰岛素(Fins)、高密度脂蛋白胆固醇(HDL)、甘油三酯(TG)、尿酸(UA)均有显著性差异(P<0.05或P<0.01);DR与非DR两组间仅糖尿病病程、SBP、空腹C肽(FCP)有显著性差异(均P<0.01);DPN与非DPN两组间年龄、糖尿病病程、HbA1c、TC、LDL有显著性差异(P<0.05或P<0.01)。(3)Logistic回归结果显示,DN与SBP、HbA1c、FBS、HDL、UA、糖尿病病程有关(OR值分别为1.022、1.098、1.075、0.501、1.004,1.048,P<0.05或P<0.01);DR与SBP、HbA1c、糖尿病病程有关(OR值分别为1.017、1.102、1.097,P<0.05或P<0.01);DPN与HbA1c、LDL、糖尿病病程、年龄有关(OR值分别为1.226、1.370、1.041、1.058,P<0.05或P<0.01)。结论对于老年2型糖尿病患者,DN、DR、DPN均与糖尿病病程和HbA1c有关,控制血糖对防治微血管病变意义重大,综合控制血糖、血压、血脂、尿酸可以更好的防治糖尿病微血管并发症。

The relative factors analysis of diabetic microvascular complications in elderly type 2 diabetic patients in hospital

Objective To analyze the prevalence rate of diabetic microvascular complications and the relative factors of them in the elderly type 2 diabetic patients.Methods 876 patients of more than 60 years old who were hospitalized in Beijing Hospital from 2003 to 2010 were analyzed by retrospective analysis.These patients were divided into diabetic nephropathy(DN),non-diabetic nephropathy(NDN),diabetic retinopathy(DR),non-diabetic retinopathy(NDR),diabetic peripheral neuropathy(DPN) and non-diabetic peripheral neuropathy(NDPN)groups.The clinical characteristics were compared to analyze relative factors of DN,DR,DPN.Results The prevalence rate of DN,DR and DPN were 34.5%,42.4%,82.3% respectively.There were statistical significant differences between DN group and NDN group in BMI,duration of diabetes and hypertension,systolic and diastolic blood pressure,fasting blood sugar,glycated hemoglobin(HbA1c),fasting insulin,HDL,TG,UA(P<0.01 or P<0.05).There were statistical significant differences between DR group and NDR group in age,duration of diabetes and fasting C peptide(P>0.01).And there were statistical significant differences between DPN group and NDPN group in age,duration of diabetes,HbA1c,TC,LDL and fasting C peptide(P<0.01 or P<0.05) Logistic regression analysis showed that DN was relative with SBP,HbA1c,FBS,HDL,UA,duration of diabetes(OR were 1.022,1.098,1.075,0.501,1.004,1.048 respectively,P<0.05 or P<0.01),DR was relative with SBP,HbA1c,duration of diabetes(OR were 1.017,1.102,1.097 respectively,P<0.05 or P<0.01);DPN was relative with HbA1c,LDL,duration of diabetes,age(OR were 1.226,1.370,1.041,1.058 respectively,P<0.05 or P<0.01).Conclusions In the elderly type 2 diabetic patients,DN,DR,DPN were all relative with duration of diabetes and HbA1c.So it is very important to control blood sugar to prevent and treat diabetic microvascular complications,and it will be better if controlling blood sugar,blood pressure,blood lipid and uric acid comprehensively.