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[目的]通过以上海市某区社区管理2型糖尿病患者为基础的横断面研究,分析社区管理2型糖尿病控制情况及其影响因素。[方法]采用系统抽样方法,抽取上海市某区10个社区在册管理的735例2型糖尿病患者,采用问卷调查、体格检查和实验室检查相结合的方法,分析患者综合管理现状和血糖控制情况。并采用多因素logistic回归分析血糖控制的影响因素。[结果]患者血糖控制理想率(HbA1c<6.5%)为23.7%;血压控制理想率(<130/80 mmHg)为18.0%;总胆固醇、三酰甘油、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇控制理想率分别为34.0%、57.1%、42.3%和25.0%;体质指数(BMI)和腰臀比(WHR)控制理想率分别为40.5%和37.3%。病程(H=27.976,P<0.05)和胰岛素使用(H=10.953,P<0.05)是影响患者血糖控制的重要因素;在调整性别、年龄、病程和药物使用等混杂因素后,影响血糖控制的主要因素包括:患者BMI控制水平(aOR=1.437,95%CI:1.002~2.060)和WHR控制水平(aOR=1.417,95%CI:1.031~1.948)、随访时间(aOR=1.016,95%CI:1.007~1.025)和随访的规范性(aOR=0.107,95%CI:0.074~0.153)等。[结论]该区社区管理2型糖尿病患者血糖、血压和血脂控制不够理想;影响患者血糖控制的主要因素包括:病程、胰岛素使用、体质指数、腰臀比和社区随访的规范性。
[Objective] To analyze the community-based management of type 2 diabetes mellitus and its influencing factors through a cross-sectional study based on community-based management of type 2 diabetes mellitus in a district in Shanghai. [Methods] A total of 735 patients with type 2 diabetes who were registered in 10 communities in a district of Shanghai were sampled by systematic sampling method. The methods of questionnaire, physical examination and laboratory examination were used to analyze the status of patients’ comprehensive management and the control of blood glucose . Multivariate logistic regression was used to analyze the influencing factors of glycemic control. [Results] The ideal rate of blood glucose control (HbA1c <6.5%) was 23.7%; the ideal rate of blood pressure control (<130/80 mmHg) was 18.0%; total cholesterol, triglyceride, high density lipoprotein cholesterol and low density lipoprotein The ideal rates of cholesterol control were 34.0%, 57.1%, 42.3% and 25.0%, respectively. The ideal control rates of BMI and WHR were 40.5% and 37.3%, respectively. The duration of treatment (H = 27.976, P <0.05) and insulin use (H = 10.953, P <0.05) were the important factors influencing glycemic control in patients. After adjusting for gender, age, course of disease and drug use, The main factors included the control of patients with BMI (aOR = 1.437, 95% CI: 1.002-2.060) and WHR control (aOR = 1.417, 95% CI: 1.031-1.948) 1.007 ~ 1.025) and follow-up of normative (aOR = 0.107, 95% CI: 0.074 ~ 0.153) and so on. [Conclusion] The control of blood glucose, blood pressure and blood lipids in patients with type 2 diabetes mellitus in community management in this area is not satisfactory. The main factors influencing blood glucose control in patients in this community include duration of disease, insulin use, body mass index, waist - hip ratio and community follow - up.