云南5家三甲医院老年2型糖尿病患者血糖控制现状及影响因素  

Current status and influencing factors of glycemic control in elderly patients with type 2 diabetes mellitus in five third-grade class-A hospitals in Yunnan

作　　者：王继花 杨秋萍[1] 鞠海兵 于南南[3] 周红坚[4] 杨怡 Wang Jihua;Yang Qiuping;Ju Haibing;Yu Nannan;Zhou Hongjian;Yang Yi(Therapy Department, the First Affiliated Hospital of Kunming Medical University, Kunming 650000, China;Institute of Endocrinology, Chengdu Military Area Command Kunming Hospital, 650000 Kunming, China;Institute of Endocrinology, Kunming Medical University Second Affiliated Hospital, Kunming 650000, China;Therapy Department, Yunnan Yuxi City People′s Hospital, Yuxi 653100, China;Endocrinology Department, Chuxiong People′s Hospital, Chuxiong 675000, China)

机构地区：[1]昆明医科大学第一附属医院干疗科,650000 [2]成都军区昆明总院内分泌科,650000 [3]昆明医科大学第二附属医院内分泌科,650000 [4]云南玉溪市人民医院干疗科,653100 [5]楚雄州人民医院内分泌科,675000

出　　处：《中华临床医师杂志（电子版）》2019年第2期116-119,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的 了解云南三甲医院老年2 型糖尿病(T2DM)患者糖化血红蛋白(HbA1c)达标现状及其影响因素。方法 于2015 年10 月至2016 月5 月,选取云南5 家三甲医院老年T2DM 患者151 例作为研究对象,进行人口学信息、体质量指数(MBI)、血糖、血压的数据统计,评估血糖控制情况,分析其影响因素。采用单因素方差分析比较不同年龄阶段组间空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)的差异,采用t 检验比较不同文化程度组之间、不同BMI组之间、不同糖尿病病程组之间、不同血压组之间FPG、2 h PG 及HbA1c 的差异。结果 年龄(73.4±7.4)岁,病程(11.4±8.0)年,HbA1c(8.8±2.2)%,HbA1c < 7.0%的患者29 例(19.2%,29/151),BMI(24.3±3.6)kg/m2,BMI < 24 kg/m2 的患者占50.3%(76/151),FPG < 7.0 mmol/L 占33.1%(50/151),2 h PG < 10.0 mmol/L 占23.8%(36/151);按年龄60~69 岁、70~79 岁、≥ 80 岁分组,HbA1c 组间比较[(8.1±2.0)% vs (8.9±1.8)% vs (9.2±2.5)%],差异具有统计学意义(F=3.711,P=0.027)、2 h PG 组间比较[(11.6±3.1)mmol/L vs (14.9±5.0)mmol/L vs (14.4±5.7)mmol/L],差异具有统计学意义(F=5.829,P=0.004),FPG 组间比较[(7.7±2.6)mmol/L vs (9.5±3.6)mmol/Lvs (9.3±3.4)mmol/L],差异无统计学意义(F=2.948,P=0.056);初中及以下组及高中及以上组间,HbA1c 组间比较[(9.0±2.2)% vs (8.2±2.0)%],差异具有统计学意义(t=2.269,P=0.025),FPG、2 h PG 组间比较,差异无统计学意义(P > 0.05);按照BMI < 24 kg/m2、≥ 24 kg/m2 分组,HbA1c、FPG、2 h PG 组间差异均无统计学意义(P > 0.05);按照血压是否达标,HbA1c、FPG、2 h PG 组间差异均无统计学意义(P > 0.05)。按照糖尿病病程< 10 年、≥ 10 年分组,HbA1c、FPG、2 h PG 组间差异均无统计学意义(P > 0.05)。结论 云南5 家三甲医院老年T2DM 患者血糖控制与年龄、文化程度有关,随着年龄增加血糖控制较差,文化程度越高,血糖控制越好。BMI、血压、糖尿病病程对血糖控制影响不明显。Objective To know about the status of glycosylated hemoglobin (HbA1c) and its influencing factors in elderly patients with type 2 diabetes mellitus (T2DM) in third-grade class-A hospital of Yunnan Province. Methods From October 2015 to May 2016, 151 elderly patients with T2DM in five thirdgrade class-A hospitals in Yunnan were selected as subjects for demographic information, body mass index, blood glucose and blood pressure. Evaluate compliance rate of HbA1c < 7.0%, analysis of its influencing factors. Results The age of (73.4±7.4) years, the course of disease (11.4±8.0) years, glycosylated hemoglobin (HbA1C)(8.8±2.2)%, HbA1c < 7.0% of patients accounted for 19.2%, BMI (24.3±3.6) kg/m2 Patients with BMI < 24 kg/m2 accounted for 50.3%, fasting blood glucose (FPG)< 7.0 mmol/L accounted for 33.1%, and postprandial 2 h blood glucose (2hPG)< 10. 0 mmol/L accounted for 23.8%;Groups by age 60 to 69 years, 70 to 79 years, and ≥ 80 years old, there were statistically significant differences between HbA1c group [(8.1±2.0)% vs (8.9±1.8)% vs (9.2±2.5)%, F=3.711, P=0.027] and 2 h PG group [(11.6± 3.1) mmol/L vs (14.9±5.0) mmol/L vs (14.4±5.7) mmol/L, F=5.829, P=0.004]. There was no significant difference in the FPG groups [(7.7±2.6) mmol/L vs (9.5±3.6) mmol/L vs (9.3±3.4) mmol/L, F=2.948, P=0.056]. According to the degree of education: junior high school and below, high school and above, the HbA1c group was statistically significant [(9.0±2.2)% vs (8.2±2.0)%, t=2.269, P=0.025], there was no significant difference in FPG and 2 h PG group (P > 0.05);There were no significant differences in the HbA1c, FPG, and 2 h PG groups according to BMI < 24 kg/m2,≥ 24 kg/m2 group;According to whether the blood pressure was up to standard, There were no significant differences in HbA1c, FPG, and 2 h PG groups (P > 0.05). There were no significant differences in the HbA1c, FPG, and 2 h PG groups according to the duration of diabetes < 10 years and ≥ 10 years (P > 0.05). Conclusions The blood glucose control of elderly T2

关 键 词：云南 老年 糖尿病 2 型 血糖控制 

分 类 号：R587.1[医药卫生—内分泌]