社区老年糖尿病人群血管并发症、合并症的发生情况及其影响因素  

Vascular complications, main coexisting illnesses and influence factors of elderly diabetic population in community

作　　者：汤文璐[1] 王永铭[1] 杜文民[2] 程能能[1] 陈斌艳[1] 

机构地区：[1]复旦大学药学院药理学教研室,上海200032 [2]上海市药品不良反应监测中心,上海200040

出　　处：《中国临床药学杂志》2007年第1期20-24,共5页Chinese Journal of Clinical Pharmacy

摘　　要：目的了解老年糖尿病(DM)人群中DM慢性并发症(微血管病变、大血管病变及神经病变等)和主要合并症(包括高血压、血脂代谢异常、肥胖等)的发生情况以及血管并发症的影响因素。方法采用横断面研究的方法,收集社区老年DM人群资料,并把DM血管并发症作为因变量,对其影响因素进行非条件logistic回归分析。结果老年DM慢性并发症以及高血压、血脂代谢紊乱、肥胖等合并症的发生率很高;经济水平较低社区、发病年限长、有DM家族史、医疗费支付有困难、空腹血糖控制不良、急性并发症、主要合并症是导致社区老年DM人群微血管并发症的主要独立因素;吸烟、嗜甜食、医疗费支付有困难、急性并发症、主要合并症是导致社区老年DM人群大血管并发症的主要独立因素。结论老年糖尿病人群糖尿病并发症及合并症的影响因素很多,这一方面说明其病情的复杂性,另一方面也为更好地控制其发生和发展及有效地降低致残率和致死率提供了综合控制的手段。AIM To learn the diabetic chronic complications （neuropathy, microvascular and macrovascular complications）, main coexisting illnesses （including hypertension, dyslipidaemia, obesity, et al. ） and influence factors of elderly diabetic population in community. METHODS By cluster sampling from five administrative areas of Shanghai, the sample size was 3 259 subjects with clinically diagnosed elderly diabetes mellitus （DM）. A door-to-door retrospectively pharmacoepidemiological survey was conducted and we established a monitoring system of antidiabetic drugs in elderly diabetic population in Shanghai. We investigated the incidence of diabetic chronic complications, main coexisting illnesses of elderly diabetic population and identified possible risk factors in logistic regression. RESULTS A total of 3 040 subjects （ 1 913 females and 1 127 malas） with clinically diagnosed elderly DM were finally enrolled in the study, dropout rate was 7.20%. The incidence of diabetic chronic complications, main coexisting illnesses of elderly diabetic population was very high. Community of low living standard, long course of disease, having familial history, difficult to pay medical cost, bad level of fasting plasma glucose, acute complications and main coexisting illness were main independent risk factors of microvascular complications; and smoking, addicted sweetmeats, difficult to pay medical cost, acute complications, main coexisting illnesses were main independent risk factors of macrovascular complications in elderly DM. CONCLUSION The diabetic chronic complications, main coexisting illnesses of elderly diabetic population in community have many influence factors, which on one hand state the complexity of elderly DM, and on the other hand gave us many useful and practical methods to control its occurrence, development and reduce the morbidity and mortality of elderly DM.

关 键 词：老年糖尿病 血管并发症 合并症 logis如回归 

分 类 号：R587.1[医药卫生—内分泌]