老年糖尿病住院患者病死率及死因分析

目的：了解老年糖尿住院患者病死率及主要死亡原因，方法：回顾和总结１９９２年至１９９９年间的住院患者中，老年糖尿病患者住院情况及２４８例死亡病例的死亡时间和原因，并与非老年糖尿病患者比较，结果：８年中，老年糖尿病病患者占糖尿病住院患者的比例呈显著增加趋势（１９９２－１９９５年为５９．９３％，１９９６－１９９９年为６７．６３％，Ｐ＜０．００１），老年糖尿病死亡病例占有所有糖尿病死亡病例的８５．８％，老年糖尿病患者病死率（７．８％）明显高于非老年糖尿病患者（２．３％，Ｐ＜０．００１），并随年龄增加而显著上升（６０－６９岁组４．７２％，７０－７９岁组１１．３４％，８０岁以上组２３．６０％，Ｐ＜０．００１），男性病死率（９．６１％）显著高于女性（５．８２％，Ｐ＜０．００１），老年糖尿中层得前５位死因顺序是：心血管疾病，脑血管疾病，胖发肿瘤，糖尿病肾病，感染，死于心，脑，肾疾病的病例中，７６．６％伴高血压，结论：老年糖尿病患者病死率随年龄增长而增高，男性显著高于女性，心，脑，肾并发症是其最重要的死亡原因，高血压是其主要危险因素，严格控制高血糖的早期控制血压，对防治糖尿病并发症和降低病死率有重要意义。

The analysis of death rate and death causes of senile diabetic inpatients

Objective To understand the death rate and the main death causes of the senile diabetic inpatients. Methods The histories of all the death cases of senile diabetic inpatients in this hospital from 1992 to 1999 were reviewed. The death rate and causes of senile diabetics were compared with those of the non-senile diabetics. Results Senile diabetics among the total diabetic inpatients increased within 8 years (56.93% during 1992-1995 vs. 67.63% during 1996-1999,P<0.01). A total of 248(162 males, 86 females) senile deaths and 41 (23 males,18 females) non-senile deaths were recorded with the death rate of the seniles being 85.8%, the morbidity of the senile diabetics being 7.84% vs. that of the non-senile diabetics of 2.31%(P<0.001). The death rate was significantly increased with the age (60-69 yrs group being 4.72%, 70-79 yrs group being 11.34%, >80 yrs group being 23.60%, P<0.001), with the death rate of males being higher than that of female (9.61% vs.5.82%,P<0.001) in senile but not in non-senile group. The main death causes were in the order of cardiovascular complications, stroke, tumor, diabetic nephrosis, infection in senile group, and diabetic ketone acidosis, tumor, diabetic nephrosis, infection, stroke in non-senile group. Out of these, 76.6% of the death with cardiac infarction, stroke, and diabetic nephropathy were complicated with hypertension. Conclusions The death rate of senile diabetics increased with age and was significantly higher in males than in females; the main death causes were vascular complications with the hypertension being one of the main risk factors. Improvement of blood glucose and blood pressure may lower the death rate in senile diabetic patients.