糖尿病并发眼病相关危险因素分析

目的探讨糖尿病性眼病的患病相关影响因素,为糖尿病性眼病的防治提供科学依据。方法以本院确诊的274例2型糖尿病患者(其中84例并发眼病)为研究对象,以实验室检测和问卷调查相结合的方式,收集可能影响糖尿病行眼病发生的危险因素,采用Mantel-Haenszel卡方检验对可能因素进行单因素分析,并建立多因素Logistic回归模型,筛检糖尿病性眼病发病的危险因素。结果单因素分析显示,糖尿病性眼病的患病与否和患者年龄、病程、血压、血糖控制以及糖化血红蛋白水平、糖尿病自我管理行为等因素有关(P0.05)。Logistic回归模型分析显示,患者年龄、病程、高血压、糖化血红蛋白水平、血糖控制情况及糖尿病自我管理行为为影响糖尿病患者并发眼部疾患的独立危险因素(P0.05)。结论年龄、病程、高血压、糖化血红蛋白水平、血糖控制情况以及糖尿病自我管理行为为影响糖尿病性眼病患病的重要因素。     

滕州地区2型糖尿病患者血糖、血脂、血压控制情况及其影响因素

目的 探讨2型糖尿病患者血糖、血脂、血压控制情况及其影响因素。方法 以2018年4月至2019年9月在本院就诊的2型糖尿病患者322例为调查对象。采用问卷调查的方式收集患者性别、年龄、吸烟史、饮酒史、受教育程度、糖尿病病程、居住地、服药情况;现场测量患者安静状态下的收缩压和舒张压。结果 血糖控制达标率为41.93%,血脂控制达标率为47.52%,血压控制达标率为25.16%。不同性别、年龄、受教育程度、糖尿病病程、居住地、服药情况的2型糖尿病患者血糖控制达标率之间比较差异均有统计学意义(均P<0.05);不同吸烟史、饮酒史、受教育程度、糖尿病病程、居住地、服药情况的2型糖尿病患者血脂控制达标率之间比较差异均有统计学意义(均P<0.05);不同性别、年龄、吸烟史、饮酒史、受教育程度、居住地、服药情况的2型糖尿病患者血压控制达标率之间比较差异均有统计学意义(均P<0.05)。多因素Logistic回归分析显示,性别、受教育程度、服药情况是2型糖尿病患者血糖控制水平的独立影响因素(均P<0.05),饮酒史、糖尿病病程、服药情况是2型糖尿病患者血脂控制水平的独立影响因素...     

湖州市织里镇2型糖尿病患者血糖控制现状与影响因素分析

目的了解浙江省湖州市织里镇2型糖尿病患者的血糖控制情况,探讨其影响因素。方法选取湖州市织里镇社区卫生服务中心HIS系统中2014年1月—2016年12月明确诊断并建档管理的2型糖尿病患者1 595例。采集并整理患者资料,计数资料采用χ~2检验,影响空腹血糖值的危险因素采用多因素Logistic回归分析。P0.05为差异有统计学意义。结果血糖控制的达标率仅为13.17%(210/1 595);文化水平、在岗情况、身体质量指数(BMI)、饮酒、体育锻炼、运动时间、病程长短、服药依从性、用药方式、总胆固醇水平、甘油三酯水平、合并高血压等因素对血糖控制的影响有统计学意义(均P0.05);而性别、年龄、吸烟对血糖控制的影响无统计学意义(均P0.05)。多因素Logistic回归分析结果显示,患者年龄≥70岁、病程≥10年、BMI≥28.0 kg/m~2、TC≥5.2 mmol/L、合并高血压是2型糖尿病患者血糖控制的危险因素(均P0.05)。结论湖州市织里镇2型糖尿病患者的血糖控制达标率偏低,患者年龄≥70岁、病程≥10年、BMI≥28.0 kg/m~2、TC≥5.2 mmol/L、合并高血压是2型糖尿病患者血糖控制的危险因素。     

安徽某地农村社区高血压人群空腹血糖的年龄、性别差异

目的探讨安徽某地农村社区45～75岁原发性高血压人群空腹血糖与年龄的关系以及性别间差异。方法采用整群抽样抽取45～75岁原发性高血压患者进行问卷调查、体格检查和生化检测。结果纳入分析的研究对象共8562人,空腹血糖受损检出率为男性6.0%,女性6.9%,糖尿病检出率为男性3.5%,女性4.9%。调整了体质指数、吸烟、饮酒以及受教育程度后,多元回归分析显示,男性空腹血糖水平与年龄无相关性;女性高年龄组空腹血糖水平升高（OR=1.7,95%CI：1.15～2.39,P=0.01,）。结论安徽某地农村社区高血压患者中空腹血糖受损以及糖尿病检出率不高,空腹血糖水平女性高于男性,女性空腹血糖水平随年龄增加而升高,而男性空腹血糖水平与年龄无相关性。     

影响2型糖尿病老年患者并发周围神经病变的logistic分析

目的 探讨2型糖尿病老年患者并发周围神经病变的影响因素。方法 选取2016年2月—2018年7月本院治疗的2型糖尿病老年患者120例作为研究对象,统计并发周围神经病变发生情况,根据有无发生周围神经病变分为DPN组57例和非DPN组63例,并对其影响因素进行调查分析。结果 DPN组患者与非DPN组患者的年龄、糖尿病病程、吸烟史、饮酒史、高血压病史、高血脂病史、BMI指数、FPG、HbA1c、UA水平差异有统计学意义(P<0.05),DPN组患者与非DPN组患者的性别、ALT、AST水平差异无统计学意义(P>0.05);Logisitic回归分析结果显示,年龄、糖尿病病程、吸烟史、饮酒史、高血压病史、高血脂病史、BMI指数、FPG、HbA1c、UA水平是2型糖尿病老年患者并发周围神经病变的影响因素。结论 年龄、糖尿病病程、吸烟史、饮酒史、高血压病史、高血脂病史、BMI指数、FPG、HbA1c、UA水平是2型糖尿病老年患者并发周围神经病变的影响因素,应积极采取有效措施进行控制糖尿病周围神经病变的发生与发展,提高2型糖尿病老年患者的生活质量。     

新港社区老年人2型糖尿病并发冠心病的危险因素分析

目的探讨社区老年人2型糖尿病并发冠心病的危险因素。方法根据194例2型糖尿病患者是否并发冠心病．分为并发冠心病组与未并发冠心病组，并记录性别、年龄、体重指数、空腹血糖、餐后2h血糖、血脂、血压等资料，对多个危险因素作单因素及Logistic回归模型多因素分析。结果单因素分析显示并发冠心病组的年龄、病程、性别、脑梗死、吸烟、体重指数（BMI）、收缩压、空腹血糖（FPG）、餐后2h血糖（2hPGG）、三酰甘油（TG）、载脂蛋白（Apo）-B与未并发冠心病组的差异有统计学意义，多因素分析结果表明年龄、病程、收缩压、FPG、2hPGG、TG、脑梗塞、吸烟与并发冠心病显著相关。结论积极预防和干预年龄、病程、收缩压、FPG、2hPGG、TG、脑梗塞、吸烟等危险因素，有助于降低糖尿病患者并发冠心病的发病率。     

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:研究2型糖尿病合并高血压患者空腹血糖控制相关因素。方法:本文选取2016年1月份至2017年6月份收治的2型糖尿病合并高血压患者156例,采用医院自行设计的调查问卷对患者空腹血糖控制相关因素进行调查。结果:年龄、性别、地区、高密度脂蛋白、总胆固醇、空腹血糖、血清肌酐、血清尿酸等因素影响糖尿病合并高血压患者控股血糖控制水平;地区、血压水平、总胆固醇、甘油三酯是糖尿病合并高血压患者的空腹血糖控制影响的单因素;地区、血压水平、糖尿病病程是糖尿病合并高血压患者的空腹血糖控制影响的多因素。结论:为了提升2型糖尿病合并高血压患者空腹血糖控制效果,需要加大对空腹血糖控制影响的单因素和多因素进行控制,加强血糖管理,帮助患者快速恢复健康。     

社区2型糖尿病患者眼病患病率及相关因素分析

[目的]了解上海市黄浦区社区2型糖尿病(T2DM)患者眼病患病率,并分析其相关因素。[方法]采用系统抽样的方法,从黄浦区社区糖尿病管理系统中抽取516名T2DM患者,采用自行设计的问卷调查采集患者的并发症情况。[结果]T2DM患者眼病患病率为28.10%,经多因素logistic回归分析筛选出糖尿病并发眼部疾变相关因素为年龄、饮食控制、血压水平、性别和病程,OR值分别为2.47、0.583、1.60、1.58和1.24(P0.05)。[结论]社区T2DM患者眼病患病率较高,年龄、饮食控制、血压水平、性别和病程是糖尿病眼部病变的主要相关因素。     

2型糖尿病并发高血压危险因素探讨

目的探讨糖尿病并发高血压的相关危险因素。方法采用以社区人群为基础的成组病例一对照研究方法。对2型糖尿病患者中126例并发高血压的病例和273例未并发高血压的对照进行问卷调查、体格检查和实验室检测。采用Logistic回归模型对糖尿病并发高血压的危险因素进行比值比（OR）及其95％CI的分析。结果单因素Logistic回归分析结果表明，体质指数、腰臀比、主食摄入量与糖尿病并发高血压之间有统计学意义，OR及其95％CI分别为1．474（1．101～1．973）。1．478（1．180～1．852）和1．349（1．098～1．657），调整混杂因素后，仍有统计学意义。未发现糖尿病确诊年龄、糖尿病病程、血糖控制情况、体育锻炼、吸烟、饮酒、血清总胆固醇、甘油三酯、高密度、低密度和极低密度脂蛋白胆固醇水平与糖尿病并发高血压之间有统计学意义。结论体质指数高、腰臀比大以及主食摄人多可增加糖尿病并发高血压发生的危险性。     

脑出血合并上消化道出血的危险因素分析

目的探讨高血压引起的脑出血并发上消化道出血的危险因素,从而指导临床治疗与预防。方法从我科的住院患者中选择高血压脑出血患者119例,对上消化道出血的危险因素进行分析。结果其中有21例患者发生上消化道出血,发病率为17.64%。脑出血合并上消化道出血与年龄、吸烟、饮酒、血糖水平有明显相关性(P0.05),是其独立的发病危险因素。结论脑出血并发上消化道出血发病率比较高,是多种因素作用的结果,要积极根据危险因素加强防治。     

影响糖尿病患者人工晶体植入术远期视力预后的相关因素分析

目的探讨影响糖尿病患者人工晶体植入术后远期视力相关因素。方法观察86例86眼行人工晶体植入术的患者,记录性别,年龄,核硬度,糖尿病病程,手术前血糖,糖化血红蛋白,胰岛素治疗,手术后第一天前房炎症反应,高血压,高血脂,分别在术后一个月与两年进行视力的多因素相关分析。结果手术后一周视力与术前血糖、糖化血红蛋白,核硬度,手术后第一天前房炎症反应,手术类型相关,(P<0.05)手术3年远视力与手术前糖化血红蛋白水平,高血压,高血脂,胰岛素治疗,糖尿病病程相关(P<0.05)。结论糖化血红蛋白控制好的患者人工晶体植入术会获得较好的远期视力,糖尿病病程短,不伴有高血压、高血脂的患者手术治疗后视力提高较大。     

Azotemia in cancer patients during inpatient rehabilitation

This paper presents a study of the relationship between prerenal azotemia and rehabilitation outcomes of cancer patients. A retrospective chart review of 70 patients who underwent inpatient rehabilitation in a tertiary cancer center was undertaken. Eight patients with creatinine values >1.5 were excluded. The remaining 62 patients were divided into 2 groups according to the blood urea nitrogen/creatinine (BUN/Cr) ratio: 27 (44%) in the prerenal azotemia group (BUN/Cr > or = 20) and 35 (56%) in the non-azotemic group (BUN/Cr < 20). Age, gender, <10 g/dL of hemoglobin, co-morbidity (diabetes mellitus and/or hypertension), discharge destiny and median rehabilitation length of stay were not significantly different in these 2 groups. Prerenal azotemia was present in a significant number of cancer patients, but it did not impact the length of rehabilitation stay or discharge destiny.     

血糖波动和NF-κB与糖尿病大鼠肾脏病变的关系

摘要:目的　观察血糖波动和核转化因子κB（NF-κB）与糖尿病大鼠肾脏病变的关系。方法　将SPF级SD大鼠40只,随机分为4组:正常对照组、正常血糖波动组、糖尿病稳定性高血糖组和糖尿病血糖波动组。采用链脲佐菌素（STZ）60 mg/kg腹腔注射建立糖尿病模型。血糖波动组每天8:00和14:00腹部皮下注射胰岛素及灌葡萄糖造成血糖波动模型。实验9周后测定体重、肾指数（KI）、平均血糖（MBG）、每日血糖水平标准差（SDBG）、最大血糖波动幅度（LAGE）、肌酐（Cr）、尿素氮（BUN）、糖化血红蛋白（HbA1c）、24 h尿微量白蛋白含量,同时用蛋白免疫印迹法测定各组肾脏组织匀浆NF-κB蛋白表达,光镜下观察肾脏组织结构变化。结果　正常对照组与正常血糖波动组间各指标差异无统计学意义,糖尿病稳定性高血糖组和糖尿病血糖波动组较正常对照组与正常血糖波动组KI、MBG、SDBG、LAGE、Cr、BUN、HbA1c、24 h尿微量白蛋白及NF-κB蛋白表达明显升高（P＜0.01）,体重明显降低（P＜0.01）;糖尿病血糖波动组与糖尿病稳定性高血糖组比较,差异有统计学意义（P＜0.05）;肾脏组织形态学观察显示,肾小球体积增大、囊腔扩张破裂,毛细血管内皮细胞基底膜增厚,肾小球细胞减少,炎症细胞浸润,肾小管结构模糊紊乱,糖尿病血糖波动组比糖尿病稳定性高血糖组以上病理变化更为明显。结论　血糖波动和NF-κB与糖尿病大鼠肾脏病变的发生发展密切相关。     

2型糖尿病患者自我管理、饮食依从性、心理负担与血糖水平的相关研究

目的 了解2型糖尿病患者的自我管理知识态度行为、饮食依从性、心理负担的现状,探讨其与血糖水平之间的关联。 方法 采用随机抽样法选取2019年9月—2020年10月在潍坊市某三甲医院就诊的2型糖尿病患者330例为调查对象,应用一般资料调查表、人体指标检测表、糖尿病患者自我管理知识态度行为评价简化量表、糖尿病患者饮食行为依从性测评量表、糖尿病痛苦量表进行问卷调查,采用二元logistic回归分析自我管理、饮食依从性、心理负担的影响因素,应用Spearman相关分析自我管理、饮食依从性、心理负担的相关性,采用多重线性逐步回归分析血糖水平的影响因素。结果 330例研究对象中HbA1c<7%者共99例(30.00%),自我管理合格、饮食依从性合格、略微心理负担者分别为184、189、150例(占比:55.76%、57.27%、45.45%)。二元logistic回归分析结果显示,居住地(OR=0.495,95%CI:0.280～0.874)、病程(OR=1.771,95%CI:1.421～2.206)、因糖尿病住院次数(OR=2.481,95%CI:1.396～4.408)、是否接受过专业系统宣教(OR=3.649,95%CI:1.239～10.751)、药物饮食运动联合控制(OR=4.354,95%CI:2.419～7.838)是自我管理的影响因素;年龄(OR=1.525,95%CI:1.119～2.078)、性别(OR=2.543,95%CI:1.465～4.415)、是否接受过专业系统宣教(OR=3.085,95%CI:1.368～6.960)、药物饮食运动联合控制(OR=11.910,95%CI:6.323～22.432)是饮食依从性的影响因素;年龄(OR=0.739,95%CI:0.559～0.979)、病程(OR=0.543,95%CI:0.449～0.657)是心理负担的影响因素。自我管理与饮食依从性、与心理负担,饮食依从性与心理负担相关(r=0.586、-0.443、-0.168,P<0.05)。多重线性逐步回归分析结果显示,饮食依从性、握力、药物饮食运动联合控制、心理负担是2型糖尿病患者血糖水平的影响因素(P<0.05)。 结论 2型糖尿病患者血糖水平与饮食依从性、心理负担、联合控制方式等密切相关;制定综合防控措施,着力提高饮食依从性,提升握力水平,有助于糖尿病患者维持良好的血糖水平。     

Longitudinal study of a diabetes education and care intervention: predictors of improved glycemic control.

BACKGROUND: This study prospectively identifies those characteristics of office patients with diabetes that predict subsequent improvement in glycemic control in response to an educational intervention. METHODS: Data on demographic factors, disease characteristics, and glycemic control were obtained on a consecutive series of patients referred by their primary physician to a 4-day outpatient diabetes education and care program. Follow-up measurement of glycosylated hemoglobin (HbA1C) was obtained from the same laboratory 2 months later. Analysis using logistic response models identified baseline characteristics associated with improved HbA1C. RESULTS: Among the 169 study subjects, 74 (44 percent) had at least a 20 percent improvement in HbA1C levels 2 months after the program. Among these subjects, mean HbA1C level was 10.6 percent before and 7.4 percent 2 months after the program. Factors associated with improvement in HbA1C values in bivariate and multivariate logistic models included duration of diabetes less than 2 years (risk ratio = 1.90, 95 percent confidence interval (CI) 1.30-2.76) and initial HbA1C level greater than 10 percent (risk ratio = 2.75, 95 percent CI 2.08-4.01). Baseline functional status, health locus of control, social support, knowledge of diabetes self-care, age, weight as percentage of ideal body weight, age at diagnosis, race, sex, family history of diabetes, type of diabetes, and mode of treatment were not significant predictors of improved HbA1C. CONCLUSIONS: Patients with shorter duration of diabetes and poor baseline glycemic control were most likely to have clinically significant glycemic responses to this program. Severity of disease and regression to the mean were unable to account for this association, leaving unanswered the question of the mechanism of this association. The data also identified a group of patients who do not respond well to this educational approach and for whom novel approaches to behavior change should be considered.     

Risk factors for the incidence of hyperuricaemia: a 6-year longitudinal study of middle-aged Japanese men

BACKGROUND: Few longitudinal studies on the determinants of increase in serum uric acid (SUA) have been completed. METHODS: In all, 1445 hyperuricaemia-free (<7.5 mg/dl SUA, no medication for and no past history of hyperuricaemia) male office workers aged 30-54 years of T Corporation in Osaka, Japan were re-examined for six successive years. Subjects who were found to be hyperuricaemic or had started medication for hyperuricaemia during repeat surveys were defined as incident cases. RESULTS: Among the subjects (n = 1365) not receiving medication for hypertension, diabetes mellitus or renal disease, multivariate analysis using the Cox proportional hazards model indicated that the incidence of hyperuricaemia had significant relationships with body mass index (adjusted hazard ratio [HR] = 1.13 for a 2 kg/m2 increase; 95% CI: 1.02-1.26), mean blood pressure (HR = 1.07 for a 5 mmHg increase; 95% CI: 1.00-1.13), log triglyceride level (HR = 2.21 for a 10 mg/dl increase; 95% CI: 1.12-4.37), alcohol intake (HR = 2.33 for drinking 46.0 g of ethanol per day or more relative to non-drinking; 95% CI: 1.55-3.50) and smoking (HR = 0.65 for current-smoking relative to non-smoking; 95% CI: 0.46-0.92). Age (HR = 0.89 for a 5-year increase; 95% CI: 0.78-1.00) and haemoglobin A1c (HbA1c) (HR = 0.89 for a 0.5% increase; 95% CI: 0.78-1.00) achieved marginal significance. CONCLUSIONS: Obesity, high blood pressure, high triglyceride level, and alcohol intake are contributory factors for the development of hyperuricaemia among middle-aged Japanese men. High HbA1c level and smoking may be negative factors for the incidence of hyperuricaemia.     

1152例糖尿病合并感染患者感染相关因素及病原菌分析

目的探讨糖尿病合并感染的临床类型、相关因素和病原学特征。方法采用回顾性方法总结分析了1152例门诊和住院糖尿病合并感染患者的感染部位、年龄、病程、糖化血红蛋白水平以及病原检查结果。结果呼吸道和泌尿系感染仍然是最常见的糖尿病感染,分别占32.7%和24.5%;致病菌以革兰阴性菌为主,占67.5%。结论年龄、病程和糖尿病慢性合并症可能与感染的发生有关。     

Blood pressure reduction due to hemoglobin glycosylation in type 2 diabetic patients

Objective:

To test the hypothesis that glycosylation of hemoglobin constitutes a risk factor for hypertension.

Methods:

A total of 129 relative uniform diabetic subjects (86 women and 42 men) were enrolled in a cross sectional study. Exclusion criteria included alcohol consumption, smoking, ischemic heart disease, stroke, neoplasia, renal, hepatic, and chronic inflammatory disease. Systolic and diastolic pressures were recorded in subsequent days and mean arterial blood pressure (MAP) was determined. Hemoglobin glycosylation was measured by determining the percentage glycosylated hemoglobin (HbA1c) by means of the automated microparticle enzyme immunoassay test.

Results:

MAP was found to be independent of the concentration of HbA1c; however, correcting MAP for the variability in hematocrit, to evidence the level of vasoconstriction (or vasodilatation) showed that MAP is negatively correlated with the concentration of HbA1c (p for trend <0.05), when patients treated for hypertension are excluded from the analysis. Patients treated for hypertension showed the opposite trend with increasing MAP as HbA1c increased (p for the difference in trends <0.05).

Conclusions:

Glycosylation per se appears to lead to blood pressure reduction in type 2 diabetic patients untreated for hypertension. Treatment for hypertension may be associated with a level of endothelial dysfunction that interferes with the antihypertensive effect of HbA1c.     

Glycemic outcome not predicted by baseline psychological measures in a diabetes management program

The Northern Health Diabetes Hospital Admission Risk Program is a chronic disease management program that aims to improve the glycemic management of patients with diabetes. The aim of this project was to determine if there was any relationship between psychological characteristics and glycemic outcome in a diabetes management program. A prospective study of patients attending the diabetes management program investigated validated measures of cognition, stage of change, locus of control, self-efficacy, depression and anxiety, and quality of life. The study investigated 86 type 2 diabetes patients (mean age 59 years, 49% female). Glycemic control (HbA1c) was measured at baseline and after 12 months in the program. Glycemic control was poor on admission to the service with a mean HbA1c of 8.9%. The measures of cognition, self-efficacy, locus of control, mental health, and quality of life were not associated with improvements in HbA1c. Those participants with shorter duration of disease and more contacts with the service were significantly more likely to experience improvements in HbA1c. Psychometric data were not predictive of glycemic outcome. Rather, in this chronic disease management program, glycemia improved more in patients who were seen earlier in their disease course and managed more intensively, regardless of their psychometric status.