基于社区登记管理2型糖尿病患者全死因的回顾性队列分析  

The retrospective cohort study on all-cause mortality in patients with type 2 diabetes mellitus

作　　者：严玉洁 徐望红[3] 秦国友[3] 苏华林[2] 陈林利[2] 徐东丽[2] 许慧琳[2] YAN Yujie;XU Wanghong;QIN Guoyou(Xinhong Community Health Service Center of Minhang District,Shanghai 201107,China)

机构地区：[1]上海市闵行区新虹社区卫生服务中心,201107 [2]上海市闵行区疾病预防控制中心 [3]复旦大学公共卫生学院

出　　处：《中国糖尿病杂志》2021年第1期20-24,共5页Chinese Journal of Diabetes

基　　金：上海市自然科学基金(19ZR1445900);上海市闵行区自然科学基金(2019MHZ010)。

摘　　要：目的分析T2DM患者与当地户籍人口中全死因死亡及常见死因死亡的风险差异,为国家基本公共卫生服务DM患者管理项目进一步推进及评价提供参考。方法以上海市闵行区2004~2015年各社区卫生服务中心进行登记管理的52073例新诊断T2DM患者为研究对象,采用回顾性队列研究设计,通过与上海市生命统计系统进行数据链接,追踪研究对象全死因死亡结局。计算患者全死因和常见死因死亡率,通过研究对象全死因及常见死因相对于当地同期户籍人口的标化死亡比(SMR)及95%CI,揭示社区管理对T2DM患者全死因死亡风险的影响。结果经过349492.69人年随访,发生全死因死亡4535例,其中男2374例,女2161例,粗死亡率分别为1471.92/10万、1160.76/10万,低于全人群,SMR 95%CI为0.79(0.76,0.82)、0.83(0.79,0.86)。60岁以上男性及70岁以上女性患者死亡风险低于全人群(P<0.05)。结论经过年龄标化后,本研究T2DM患者中全死因死亡风险低于全人群,基于社区的T2DM患者管理在一定程度上可能降低T2DM患者死亡风险。Objective Analysis of the risk differences between type 2 diabetes mellitus(T2DM)patients and local registered population in all-cause death and common causes of death,and to provide evidence for the progress and evaluation of DM management program in National Public Health Services.Methods A population-based retrospective cohort study including 52073 newly diagnosed T2DM patients were conducted in Minhang district of Shanghai,China from 2004 to 2015.All T2DM patients were enrolled from the standardized management system based on local electronic information system.The occurrence of death was identified by record-linkage with the Shanghai Vital Registry.All-cause and disease-specific mortality were calculated.The standardized incidence ratio,Standardized mortality ratio(SMR)and 95%CI of registered residence population were used to estimate the risk of death in patients with T2DM.Results After 349492.69 person-years of following-up,4535 death cases were identified,including 2374 and 2161 deaths in male and female respectively.The all-cause mortality was 1471.9 per 105 person-years in men and1160.76 per 105 person-years in women respectively.A decreased risk of all-cause mortality was observed in male and female T2DM patients,with SMR 95%CI of 0.79(0.76,0.82)and 0.83(0.79,0.86),respec-tively.The mortality risk of male diabetic patients over 60 years old and female patients over 70 years old was lower than that of the general population.Conclusion The risk of all-cause mortality was lower in T2DM patients than in general population,which reflects that community-based management of type 2 diabetes may reduce the risk of death in T2DM patients.

关 键 词：糖尿病 2型 回顾性队列 全死因死亡 标化死亡比 

分 类 号：R587.1[医药卫生—内分泌]