CAJ | 학술논문

目的：探讨2型糖尿病合并慢性并发症发病时间及相关影响因素。方法回顾性分析149例2型糖尿病患者资料，采用乘积极限法（ product-limit method）进行“生存率”分析，应用对数秩检验方法（ log-rank test）比较各研究因素不同水平“生存率”是否有差异，用Cox风险比例模型进行多因素生存分析。结果有50%的糖尿病患者4.98年后即出现慢性并发症；根据乘积极限法所作的20年以内生存分析提示，149例TD2M患者中，1、3、5、10、15、20年未发生慢性并发症者占观察人数的百分比（即“生存率”）分别为65.1%、53.7%、40.9%、16.1%、6.0%、0；用Log-rank检验发现糖尿病诊断年龄、糖尿病家族史、高密度脂蛋白（HDL）这3个因素各水平之间TD2M“生存率”差异有统计学意义（P<0.05），采用逐步回归法进行多因素Cox回归分析，显示HDL异常是糖尿病合并慢性并发症的危险因素。结论随着糖尿病病程的延长，慢性并发症的发生率亦增加，无糖尿病家族史及糖尿病发病年龄晚者较对比组提前出现慢性并发症，HDL降低使糖尿病患者发生慢性并发症的时间更早。
목적：탐토2형당뇨병합병만성병발증발병시간급상관영향인소。방법회고성분석149례2형당뇨병환자자료，채용승적겁한법（ product-limit method）진행“생존솔”분석，응용대수질검험방법（ log-rank test）비교각연구인소불동수평“생존솔”시부유차이，용Cox풍험비례모형진행다인소생존분석。결과유50%적당뇨병환자4.98년후즉출현만성병발증；근거승적겁한법소작적20년이내생존분석제시，149례TD2M환자중，1、3、5、10、15、20년미발생만성병발증자점관찰인수적백분비（즉“생존솔”）분별위65.1%、53.7%、40.9%、16.1%、6.0%、0；용Log-rank검험발현당뇨병진단년령、당뇨병가족사、고밀도지단백（HDL）저3개인소각수평지간TD2M“생존솔”차이유통계학의의（P<0.05），채용축보회귀법진행다인소Cox회귀분석，현시HDL이상시당뇨병합병만성병발증적위험인소。결론수착당뇨병병정적연장，만성병발증적발생솔역증가，무당뇨병가족사급당뇨병발병년령만자교대비조제전출현만성병발증，HDL강저사당뇨병환자발생만성병발증적시간경조。
Objective To investigate the onset time and influencing factors of chronic complications in type 2 dia-betes mellitus. Methods A retrospective analysis of 149 cases of patients with type 2 diabetes was made,the rate of sur-vival was analyzed by the product limit method,and log rank test method was used to compare whether there are differences in survival rate among patients with different levels. Cox risk model was used for multivariate survival analysis. Results The median survival time was 4. 98 years among 149 cases of T2DM. The ratio without chronic complications was 65. 1% at 1 year,53. 7% at 3 years,40. 9% at 5 years,16. 1% at 10 years,6. 0% at 15 years and 0% at 20 years. Log-rank test showed that there were significant differences in survival rate among patients with different DM diagnosis age,DM family history and HDL(P<0. 05). The result of Cox regression demonstrated that low level HDL was dangerous factor of DM with chronic complication. Conclusions With the extension of the duration of diabetes,the incidence rate of chronic complica-tions are also increased. Patients with no family history of diabetes and late diabetes onset age have chronic complications of diabetes early. Low level HDL can increase the risk of chronic complications in patients with type 2 diabetes mellitus.