社区糖尿病患者的周围血管病变患病率及其影响因素研究  

The prevalence and risk factors of diabetic peripheral artery disease in Chinese communities

作　　者：秦莉 陈波[1] 牛静雅 王君[1] 王占国 武鸣 周金意[3] 张庆军[4] 周芳[4] 周正元[5] 张宁[5] 吕红艳 盛红艳[5] 王文绢[1] Qin Li;Chen Bo;Niu Jingya;Wang Jun;Wang Zhanguo;Wu Ming;Zhou Jinyi;Zhang Qingjun;Zhou Fang;Zhou Zhengyuan;Zhang Ning;Lyu Hongyan;Sheng Hongyan;Wang Wenjuan(National Center for Chronic and Non-communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China;Center for Tuberculosis Control and Prevention,Beijing Center for Disease Prevention and Control,Beijing 100035,China;Jiangsu Provincial Center for Disease Control and Prevention,Nanjing 210009,China;Hubei Provincial Center for Disease Control and Prevention,Wuhan 430079,China;Changshu Center for Disease Control and Prevention,Changshu 215500,China;Jiang'an District Center for Disease Control and Prevention,Wuhan 430014,China)

机构地区：[1]中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京100050 [2]北京市疾病预防控制中心结核病预防控制所,北京100035 [3]江苏省疾病预防控制中心,南京210009 [4]湖北省疾病预防控制中心,武汉430079 [5]常熟市疾病预防控制中心,常熟215500 [6]武汉市江岸区疾病预防控制中心,武汉430014

出　　处：《中华流行病学杂志》2022年第12期1932-1938,共7页Chinese Journal of Epidemiology

基　　金：国家重点研发计划(2017YFC1309804);世界糖尿病基金会(WDF13-805)。

摘　　要：目的了解社区管理2型糖尿病患者的周围血管病变(PAD)流行现况及影响因素。方法本研究基于中国糖尿病足预防模式项目基线调查,采用二阶段整群随机抽样的方法抽取武汉市江岸区和江苏省常熟市社区管理的2型糖尿病患者2528名,进行问卷调查、体格检查及血糖检测。采用非条件多因素logistic模型进行影响因素分析。结果糖尿病患者的PAD患病率为11.2%,<55、55~、65~、≥75岁年龄组的患病率分别为7.8%、6.0%、12.9%、22.5%。多因素分析结果显示,与<55岁年龄组糖尿病患者相比,55~、65~、≥75岁年龄组PAD患病的OR值分别为0.74(95%CI:0.43~1.28)、1.72(95%CI:1.05~2.81)、3.56(95%CI:2.07~6.11);与小学及以下文化程度糖尿病患者相比,初中、高中/中专/技校、大专及以上文化程度PAD患病的OR值分别为1.37(95%CI:0.97~1.94)、2.48(95%CI:1.73~3.55)、1.99(95%CI:1.26~3.13);现在吸烟(OR=1.49,95%CI:1.02~2.17)、现在饮酒(OR=0.45,95%CI:0.28~0.71)、餐后2 h血糖控制未达标(OR=1.72,95%CI:1.22~2.43)、心肌梗死或心绞痛史(OR=2.32,95%CI:1.50~3.61)均是糖尿病PAD的影响因素。结论社区管理糖尿病患者的PAD患病率较高,有必要在基层医疗卫生机构开展PAD常规筛查,及早发现,早期预防,减少糖尿病足的发生。Objective To investigate the prevalence and risk factors of diabetic peripheral artery disease(PAD)in patients with type 2 diabetes mellitus(T2DM)managed in primary health care in China.Methods A total of 2528 T2DM patients were selected using a two-stage cluster random sampling method based on the baseline survey of the"China Diabetic Foot Prevention Model Project."The study was conducted in 2015 among T2DM patients in 8 primary healthcare centers in Changshu county and Jiang'an district of Wuhan,China.Data collection methods included a questionnaire,body measurement,and blood glucose detection.The Ankle-Brachial Index(ABI)is the most widely used noninvasive vascular test.A binary logistic regression model was used to analyze the influence factors.Results The prevalence of PAD was 11.2%among the diabetic patients managed in primary health care in the two cities.The prevalence of PAD under 55 years old,55-years old,65-years old,and≥75 years old were 7.8%,6.0%,12.9%and 22.5%,respectively.Multivariate stepwise logistic regression identified influence factors included older age,higher education level,smoking,drinking,postprandial glucose uncontrol,and prior myocardial infarction or angina.Compared to age<55 years,the odds ratio for PAD were 0.74 for 55-years(95%CI:0.43-1.28),1.72 for 65-years(95%CI:1.05-2.81),3.56 for 75 years and above(95%CI:2.07-6.11),respectively.Compared to patients with education in primary school and below,the odds ratio was 1.37(95%CI:0.97-1.94),2.48(95%CI:1.73-3.55),1.99(95%CI:1.26-3.13)for those with education levels of junior high school,senior high school,and college,respectively.Current smoking(OR=1.49,95%CI:1.02-2.17),current drinking(OR=0.45,95%CI:0.28-0.71),postprandial glucose uncontrol(2 h postprandial plasma glucose>10.0 mmol/L:OR=1.72,95%CI:1.22-2.43),and prior myocardial infarction or angina(OR=2.32,95%CI:1.50-3.61)were influencing factors of PAD.Conclusions Despite the high prevalence of PAD in diabetes managed in primary health care;multiple risk factors are not effectively a

关 键 词：周围血管病变 糖尿病 2型 患病率 影响因素 横断面调查 

分 类 号：R587.2[医药卫生—内分泌] R181.3[医药卫生—内科学]