CAJ | 학술논문

目的比较不同医疗保健条件下老年2型糖尿病(T2DM)患者的血糖控制水平及达标情况,并分析其影响因素.方法采用横断面、现场调查方法,收集2009年5月在解放军总医院体检的老年2型糖尿病(T2DM)患者688例(老干部组),及2009年9月至2010年6月北京某社区健康状况调查数据中的老年T2DM患者409例(社区组).按《中国2型糖尿病防治指南(2010年版)》控制标准,比较两组人群的血糖控制水平及达标情况.结果老干部组的糖化血红蛋白(HbA1c)低于社区组(6.6％±1.0％比7.1％±1.4％,P＜0.05);其中,老干部组HbA1c ＜6.5％和＜7.0％的比例分别为50.6％和76.3％,均显著高于社区组的40.6％和55.7％(均P＜0.05);老干部组血糖、血压、血脂综合达标率高于社区组(11.5％比2.0％,P=0.000).≥60岁患糖尿病者HbA1c控制水平及达标率均优于＜ 60岁患病者(老干部组:6.5％±0.9％比6.8％±0.9％、79.1％比66.4％;社区组:6.9％±1.4％比7.4％±1.4％、64.9％比42.9％;均P＜0.05).Logistic逐步回归分析显示,不同保健条件、性别、糖尿病病程、糖尿病发病年龄及总胆固醇水平是影响两组人群HbA1c达标的主要因素(P＜0.05).结论老干部组T2DM患者的血糖控制水平及达标率均优于社区组;≥60岁发病的老年T2DM患者的血糖控制水平及达标率优于＜60岁发病者.
목적 비교불동의료보건조건하노년2형당뇨병(T2DM)환자적혈당공제수평급체표정황,병분석기영향인소.방법 채용횡단면、현장조사방법,수집2009년5월재해방군총의원체검적노년2형당뇨병(T2DM)환자688례(로간부조),급2009년9월지2010년6월북경모사구건강상황조사수거중적노년T2DM환자409례(사구조).안《중국2형당뇨병방치지남(2010년판)》공제표준,비교량조인군적혈당공제수평급체표정황.결과 로간부조적당화혈홍단백(HbA1c)저우사구조(6.6％±1.0％비7.1％±1.4％,P＜0.05);기중,로간부조HbA1c ＜6.5％화＜7.0％적비례분별위50.6％화76.3％,균현저고우사구조적40.6％화55.7％(균P＜0.05);로간부조혈당、혈압、혈지종합체표솔고우사구조(11.5％비2.0％,P=0.000).≥60세환당뇨병자HbA1c공제수평급체표솔균우우＜ 60세환병자(로간부조:6.5％±0.9％비6.8％±0.9％、79.1％비66.4％;사구조:6.9％±1.4％비7.4％±1.4％、64.9％비42.9％;균P＜0.05).Logistic축보회귀분석현시,불동보건조건、성별、당뇨병병정、당뇨병발병년령급총담고순수평시영향량조인군HbA1c체표적주요인소(P＜0.05).결론 로간부조T2DM환자적혈당공제수평급체표솔균우우사구조;≥60세발병적노년T2DM환자적혈당공제수평급체표솔우우＜60세발병자.
Objective To compare the status of blood glucose control in elderly type 2 diabetics under different health care levels and analyze its influencing factors.Methods Using cross-sectional and field survey methods,688 elderly type 2 diabetics aged over 60 years undergoing long-term annual physical examination at PLA General Hospital in May 2009 (veteran group) were recruited.And 409 patients aged over 60 years with type 2 diabetes were selected from a community health survey in Beijing from September 2009 to June 2010 (community group).According to the diabetic control standards of Chinese Type 2 Diabetes Prevention Guide(2010),a comparison of blood glucose control status between two groups were conducted.Results The mean HbA1c level was 6.6％ ± 1.0％ in the veteran group.And there were 50.6％ patients with HbA1c ＜6.5％ and 76.3％ with HbA1c ＜7％.In the community group,the mean HbA1c level was 7.1％ ± 1.4％ and the success rates of HbA1c were 40.6％ and 55.7％ respectively.The status of blood glucose control in the veteran group was significantly superior to that in the community group (P ＜ 0.05).The comprehensive rates of achieving control target goals for blood glucose,blood pressure and blood lipids were higher in thc vctcran group than that in the community group(11.5％ vs 2.0％,P ＜0.001).The success rates of HbA1c for diabetics diagnosed after age 60 years were better than those diagnosed before age 60 years (P ＜ 0.05).Logistic regression analysis showed that different health care levels,gender,duration of diabetes,age of onset and total cholesterol were crucial factors for achieving target goal of HbA1 c in both groups (P ＜ 0.05).Conclusion The status of blood glucose control was much better in the veteran group than that in the community group.And the blood glucose control level in the patients diagnosed as diabetes after age 60 years was superior to that in those diagnosed before age 60 years.