CAJ | 학술논문

目的了解社区2型糖尿病(T2DM)患者的经济水平与其血糖控制的关系,为北京市社区T2DM患者纵向管理制定个体化的方案提供科学依据.方法 2008年8月-2009年7月,我院与北京市多个社区卫生服务中心联合开展T2DM纵向管理项目.采用多级抽样的方法,纳入北京市5个城区中15个社区卫生服务中心,共2 887例T2DM患者自愿参加本次调查.全体参与医师经过专门培训,按统一要求调查并填写调查表,同时对患者进行体格检查及相关的实验室检查.结果 (1)不同经济水平的T2DM患者,其性别、年龄、教育程度、吸烟等指标间差异有统计学意义(P<0.05).(2)不同经济水平的患者,其糖尿病病程、体质指数、腰围、舒张压、空腹血糖、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇水平间差异有统计学意义(P<0.05).(3)按血糖水平7.0 mmol/L为标准,将血糖控制情况分为良好(血糖≤7.0 mmol/L)和差(血糖>7.0 mmol/L),经济水平由低到高4组患者的血糖控制良好率分别为40.68%、42.31%、49.69和48.05%;其中人均月收入为2 000～元的患者血糖控制最佳,与<1 000元/月的患者比较,差异有统计学意义(P=0.005).(4)调整年龄、糖尿病病程、肥胖、LDL-C等相关因素后Logistic回归分析表明,经济水平对血糖控制仍呈独立相关性,人均月收入>1 000元的患者,其血糖水平>7.0 mmol/L的风险是<1 000元/月的患者的0.868倍[OR 95%CI(0.778,0.968)];人均月收入在1 000～元、2 000～元、4 000～元的患者,其血糖>7.0 mmol/L的风险是<1 000元/月的患者的0.992倍[OR 95%CI(0.754,1.306)]、0.778倍[OR 95%CI(0.585,1.035)]和0.775倍[OR 95%CI(0.508,1.181)].结论 T2DM患者经济水平影响血糖控制,经济水平高的患者血糖水平控制得好,其中收入为2 000～3 999元/月的患者血糖控制最佳.
목적 료해사구2형당뇨병(T2DM)환자적경제수평여기혈당공제적관계,위북경시사구T2DM환자종향관리제정개체화적방안제공과학의거.방법 2008년8월-2009년7월,아원여북경시다개사구위생복무중심연합개전T2DM종향관리항목.채용다급추양적방법,납입북경시5개성구중15개사구위생복무중심,공2 887례T2DM환자자원삼가본차조사.전체삼여의사경과전문배훈,안통일요구조사병전사조사표,동시대환자진행체격검사급상관적실험실검사.결과 (1)불동경제수평적T2DM환자,기성별、년령、교육정도、흡연등지표간차이유통계학의의(P<0.05).(2)불동경제수평적환자,기당뇨병병정、체질지수、요위、서장압、공복혈당、고밀도지단백담고순、저밀도지단백담고순수평간차이유통계학의의(P<0.05).(3)안혈당수평7.0 mmol/L위표준,장혈당공제정황분위량호(혈당≤7.0 mmol/L)화차(혈당>7.0 mmol/L),경제수평유저도고4조환자적혈당공제량호솔분별위40.68%、42.31%、49.69화48.05%;기중인균월수입위2 000～원적환자혈당공제최가,여<1 000원/월적환자비교,차이유통계학의의(P=0.005).(4)조정년령、당뇨병병정、비반、LDL-C등상관인소후Logistic회귀분석표명,경제수평대혈당공제잉정독립상관성,인균월수입>1 000원적환자,기혈당수평>7.0 mmol/L적풍험시<1 000원/월적환자적0.868배[OR 95%CI(0.778,0.968)];인균월수입재1 000～원、2 000～원、4 000～원적환자,기혈당>7.0 mmol/L적풍험시<1 000원/월적환자적0.992배[OR 95%CI(0.754,1.306)]、0.778배[OR 95%CI(0.585,1.035)]화0.775배[OR 95%CI(0.508,1.181)].결론 T2DM환자경제수평영향혈당공제,경제수평고적환자혈당수평공제득호,기중수입위2 000～3 999원/월적환자혈당공제최가.
Objective To investigate economic status and blood glucose (BG)control of type 2 diabetes mellitus (T2DM) in 15 communities of Beijing.Methods A total of 2887 T2DM patients were enrolled by multi-stage sampling method in this study in 15 communities.All physicians involved were specially trained and filled in the questionnaire according to uniform requirements.The patients received physical examinations and relevant laboratory tests.Results There was significant difference in gender,age,educational level,smoking,and duration of diabetes,body mass index,waist circumference,diastolic blood pressure,and the levels of fasting glucose,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol between T2DM patients in difference economic levels (P＜0.05).Taking 7.0 mmol/L as standard BG level and dividing BG control into "good"(≤7.0 mmol/L) and "bad"(＞7.0 mmol/L),the good BG control of 4 groups in different economic levels (from low to high) were 40.68%,42.31%,49.69,48.05%,respectively,and the glucose level was significantly lower in the group whose income was over 2000～4 000(￥)/M than in group whose income below 1 000(￥)/M (P=0.005).After adjustment of such factors as age,duration of diabetes,obesity and LDL-C,Logistic multi-regression analysis showed that economic level was independently correlated with BG control,that the BG risk (＞7.0 mmol/L) of patients with over 1000(￥)/M income was 0.868 times that of those with below 1000(￥)/M[ OR 95%CI(0.778,0.968)],and that of those with 1000～2 000,2000～4000,4000＞(￥)/M income was 0.992[OR 95%CI(0.754,1.306)],0.778[OR 95%CI(0.585,1.035)],0.775[OR 95%CI(0.508,1.181)]times that of those with below 1000(￥)/M income.Conclusion The economic level is of effect on BG control,patients with better income control better,and those with 2000～3 999 (￥)/M income control best.],0.778[