上海社区糖尿病综合管理现状及相关因素分析  

Analysis on the status of comprehensive management and related factors of diabetes in Shanghai community

作　　者：曾媛媛[1] 肖元元[1] 祝超瑜[1] 刘梦丹 高清歌[1] 徐立[1] 蒋伏松[1] 魏丽[1] ZENG Yuanyuan;XIAO Yuanyuan;ZHU Chaoyu;LIU Mengdan;GAO Qingge;XU Li;JIANG Fusong;WEI Li(Department of Endocrinology and Metabolism,Shanghai Jiao Tong University Affiliated 6th People＇s Hospital,Shang-hai 200233,China)

机构地区：[1]上海交通大学附属第六人民医院内分泌代谢科,上海200233

出　　处：《中国医药导报》2018年第26期26-29,共4页China Medical Herald

基　　金：上海申康医院发展中心临床科技创新基金资助项目(SHDC20 16632)

摘　　要：目的了解上海泥城社区糖尿病患者综合管理情况,探讨其影响因素。方法选取2014年3~4月上海泥城社区内40岁以上符合纳入标准的糖尿病患者541例,收集患者的临床及实验室资料并进行统计分析处理,评估血糖、血压和血脂的控制率并进行相关影响因素分析。结果上海社区糖尿病患者糖化血红蛋白、血压、血脂的控制率分别为72.27%、43.44%、38.82%,3项指标达标率为5.91%。多因素Logistic回归分析显示,缺乏运动、未进行饮食控制、社区血糖监测频次低、高收缩压、高三酰甘油是影响糖尿病患者糖化血红蛋白达标的危险因素(P<0.05);高龄、文化程度低、高糖化血红蛋白、高三酰甘油是影响糖尿病患者血压达标的危险因素(P<0.05);缺乏运动、缺乏规律药物治疗、社区血糖监测频率低是影响糖尿病患者血脂达标的危险因素(P<0.05)。结论目前上海社区2型糖尿病患者综合管理水平需进一步提高,尤其需要关注高龄、文化程度低、缺乏运动、不进行饮食控制和血糖监测的患者,应加强对这部分人群的管理。Objective To investigate the comprehensive management of diabetic patients in Shanghai Nicheng community and explore its influencing factors. Methods From March to April 2014, 541 diabetic patients over 40 years old in Nicheng community of Shanghai were selected. The clinical and laboratory data were collected and analyzed statistically. The control rate of blood sugar, blood pressure, and blood lipid were evaluated, and relevant factors were analyzed. Results The control rates of glycosylated hemoglobin, blood pressure and blood lipid in diabetic patients in Shanghai community were 72.27%, 43.44% and 38.82%, respectively, the proportion of all three indicators to reach the standard was 5.91%. Multivariate Logistic regression analysis showed that lack of exercise, poor diet control, lower frequency of blood glucose monitoring, high systolic blood pressure and triglyceride levels were risk factors of HbAIo target rate of diabetic patients （P 〈 0.05）; age, illiterate, high levels of HbAIo and triglyceride were risk factors of blood pressure target rate in diabetic patients （P 〈 0.05）; lack of exercise, irregular pharmacologic treatment and lower frequency of community blood glucose monitoring were risk factors of the blood lipids target rate in diabetic patients （P 〈 0.05）. Conclusion At present, the comprehensive management level of patients with type 2 diabetes in Shanghai community needs further improvement, especially for elderly patients with low education level, lack of exercise, no diet control and blood glucose monitoring.

关 键 词：社区 糖尿病 血糖 血压 血脂 

分 类 号：R587.1[医药卫生—内分泌]