广东省住院患者糖脂代谢状况与合并症调查  

A survey of glucose and lipid metabolism and concomitant diseases among inpatients in Guangdong province

作　　者：唐宽晓[1] 余秋琼[1] 刘烈华[2] 薛耀明[3] 杨华章[4] 李璐[5] 蔡德鸿[6] 武革[7] 张帆[8] 曾龙驿[1] 林少达[9] 肖正华[10] 夏旋[1] 何筱莹[2] 徐芬[1] 翁建平[1] 

机构地区：[1]中山大学附属第三医院内分泌科,广州510630 [2]中山大学附属第一医院内分泌科 [3]南方医科大学南方医院内分泌科 [4]广东省人民医院内分泌科 [5]暨南大学第二医学院深圳市人民医院内分泌科 [6]南方医科大学珠江医院内分泌科 [7]广东医学院附属医院内分泌科 [8]北京大学深圳医院内分泌科 [9]汕头大学医学院第一附属医院内分泌科 [10]广州市第一人民医院内分泌科

出　　处：《中华内科杂志》2009年第3期196-200,共5页Chinese Journal of Internal Medicine

基　　金：广东省科学事业费计划项目（2006a36001001）

摘　　要：目的了解住院病人糖和脂代谢状态、调脂达标现状及对合并症的影响，以提高临床医务工作者对糖、脂代谢紊乱认知意识和防治水平。方法采用横断面调查方法，对广东省10家大学附属医院同期住院的8753例患者登记病史、空腹血糖（FBG），行体脂和血脂分析。已诊断糖尿病（PDM）和FBG≥5．6mmol／L未诊断糖尿病患者填写病例报告表；5．6mmol/L≤FBG≤6．9mmol/L者行口服葡萄糖耐量试验（OGTF）。结果PDM和未诊断糖尿病FBG≥5．6mmol／L资料完整者1067例。未诊断糖尿病5．6mmol／L≤FBG≤6．9mmol/L行OGTT检查者占65．8％（325／494）。PDM447例，占41．9％，新诊断糖尿病（NDM）占21．7％，糖调节异常（IGR）占29．1％，正常糖耐量（NGT）7．3％。TG水平NDM组和PDM组高于NGT组和IGR组（P值均〈0．05），HDL—C水平NGT组高于糖耐量异常各组（P值均〈0．05）。血脂异常的比例IGR组52．5％，NGT组56．4％，糖尿病（NDM＋PDM）组69．6％。22．8％PDM患者接受系统调脂治疗，达标率3．4％。IGR、NDM和PDM组BMI和腰围大于NGT组（P值均〈0．05），腰围PDM组大于IGR组（P〈0．01）。PDM组合并1种以上血管病变者占72．8％，NDM患者9．7％并发糖尿病肾病，0．2％并发糖尿病视网膜病变。结论住院糖尿病和IGR患者合并脂质代谢异常的比例显著高于NGT住院患者，以高TG和低HDL—C血症为主。住院PDM患者合并血管病变的比例显著高于其他患者，部分NDM和IGT患者已并发微血管病变。Objectives To investigate the epidemiological and clinical characteristics of dyslipidemia as well as its treatment and influence on accompanying diseases in impaired glucose status among inpatients. Methods A cross-sectional survey was conducted among the inpatients registered in ten university hospitals of Guangdong, China during the week before the Diabetes Day in 2004. The fasting blood glucose （FBG）, lipid profiles, BMI, waist to hip ratio （WHR） and concomitant disorders of the first screen during the hospitalization period were recorded. Those who had FBG level from 5.6 to 6. 9 mmol/L and not been previously diagnosed diabetes （PDM） underwent oral glucose tolerance test （OGTT）. Results Of the 8753 inpatients investigated, 1067 cases had complete medical records （CMR case） including PDM cases and previously non - diagnosed diabetes ones with FBG t〉 5.6 mmol/L. Of the previously non - diagnosed diabetes cases with FBG levels from 5.6 to 6. 9 mmol/L, 65.8% accepted OGTT. Of the CMR cases, 41.9% had PDM, 21.7% was newly diagnosed diabetes mellitus （NDM）, 29. 1% had impaired glucose regulation （IGR） and only 7.3% had normal glucose tolerance （NGT）. The TG levels in NDM and PDM group were higher than those in IGR and NGT group （P 〈0. 05, respectively）. The HDL-C levels in IGR, NDM and PDM group were lower than those in NGT group （ P 〈 0. 05, respectively）. Sixty-nine point six percent of the diabetes mellitus （DM） inpatients was accompanied with dyslipidemia and the rate was higher than those in NGT （56.4%） and IGR inpatients （52. 5%, P 〈0.05, respectively）. Only 22. 8% of the PDM inpatients underwent treatment of dyslipidaemia and just 3.4% achieved the target suggested by the guideline of ATP-Ⅲ. BMI was higher and waistline longer in the PDM and NDM inpatients than those in the NGT cases （ P 〈 0. 05, respectively）. Seventy-two point eight percent of the PDM inpatients was complicated with more than one type of vascular diseases. Nine point seve

关 键 词：葡萄糖代谢障碍 脂代谢障碍 住院病人 合并症 

分 类 号：R686[医药卫生—骨科学]