老年2型糖尿病患者HbA1c变异性的影响因素分析  

Analysis of influencing factors of HbA1c variability in elderly patients with type 2 diabetes

作　　者：刘欢[1] 莫永珍[2] 唐伟[2] 巫海娣[2] 吴玉霞 胡艳[2] 戴静[2] 宋小波[2] 俞匀[2] LIU Huan;MO Yongzhen;TANG Wei;WU Haidi;WU Yuxia;HU Yan;DAI Jing;SONG Xiaobo;YU Yun(School of Nursing, Suzhou University, Suzhou 215006, China;Diabetes Prevention and Research Center, Jiangsu Province Official Hospital, Nanjing 210024, China)

机构地区：[1]苏州大学护理学院,江苏苏州215006 [2]江苏省省级机关医院糖尿病防治研究中心,江苏南京210024

出　　处：《医药高职教育与现代护理》2022年第2期93-97,共5页Medical Higher Vocational Education and Modern Nursing

基　　金：南京医科大学专病队列研究(NMUC2020041)。

摘　　要：目的评估老年2型糖尿病患者糖化血红蛋白(HbA1c)变异性的影响因素。方法纳入2021年1月至7月在江苏省某三级医院糖尿病中心进行随访的270例老年2型糖尿病患者,收集患者就诊前两年内HbA1c测量值,计算HbA1c变异性,即调整测量次数的标准差(Adj-HbA1c-SD)。依据Adj-HbA1c-SD四分位数大小,患者被分为4组,以下四分位G1组(Adj-HbA1c-SD≤0.06)作为对照组,上四分位G4组(Adj-HbA1c-SD>0.16)作为病例组。采用独立样本t检验、非参数检验及χ^(2)检验比较组间差异,多元线性逐步回归分析评估老年2型糖尿病患者HbA1c变异性的影响因素。结果与对照组(G1组)相比,病例组(G4组)患者的PBG水平、HbA1c水平及联用胰岛素的比率更高,HDL-C水平、HbA1c测量频次及收入水平≥5000元的比率更低(P<0.05);多元线性逐步回归分析结果显示,HbA1c测量次数、HbA1c、病程、吸烟史、口服降糖药、联用胰岛素是老年2型糖尿病患者HbA1c变异性的影响因素。结论应及时关注HbA1c测量次数少、病程短、吸烟及使用胰岛素联合降糖治疗的老年2型糖尿病患者,评估HbA1c变异性大小,防止并发症的发生和进展。Objective To evaluate the influencing factors of HbA1c variability in elderly patients with type 2 diabetes.Methods From January 2021 to July 2021,a total of 270 elderly patients with type 2 diabetes who were followed up at the diabetes center of a tertiary hospital in Jiangsu Province were selected.The standard deviation adjusting the measurement times(Adj-HbA1c-SD)were calculated though HbA1c measurements obtained two years prior to the admission.Patients were divided into four groups according to the Adj-HbA1c-SD quartile.The bottom quartile G1 group(Adj-HbA1c-SD≤0.06)was seemed as the control group,and the top quartile G4 group(Adj-HbA1c-SD>0.16)was seemed as the study group.The independent sample t test,nonparametric test and χ^(2) test were adopted to compare the differences of groups.Multiple linear stepwise regression analysis was used to evaluate the influencing factors of HbA1c variability in elderly patients with type 2 diabetes.Results The PBG,HbA1c and the use of insulin were higher in the G4 group than the G1 group.However,HDL-C,measurement frequency of HbA1c and the rate of income≥5000 yuan were lower in the G4 group than the G1 group(P<0.05).Multiple linear stepwise regression analysis showed that measurement frequency of HbA1c,HbA1c,course of disease,smoking,oral hypoglycemic drugs and insulin were the influencing factors of HbA1c variability in elderly patients with type 2 diabetes.Conclusions Elderly patients with type 2 diabetes who have fewer HbA1c measurements,short course of disease,smoking and insulin combined hypoglycemic therapy need to be concerned in time to evaluate the HbA1c variability,so as to prevent the occurrence and progression of complications.

关 键 词：老年 2型糖尿病 HbA1c变异性 影响因素 

分 类 号：R58[医药卫生—内分泌]