新疆1型糖尿病患儿血糖控制及影响因素探讨  

Glycemic control and influencing factors in children with type 1 diabetes mellitus in Xinjiang

作　　者：祖丽胡玛尔·日夏提 米热古丽·买买提[1] Rixiati Zulihumaer;Maimaiti Mireguli(Pediatric Center,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China;the Children's Medical Center,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]新疆医科大学第一附属医院儿科中心,乌鲁木齐830000 [2]北京大学第一医院儿童医学中心,北京100034

出　　处：《中华儿科杂志》2025年第4期394-398,共5页Chinese Journal of Pediatrics

摘　　要：目的了解新疆单中心1型糖尿病(T1DM)患儿血糖控制情况,分析影响血糖控制的相关因素。方法横断面研究。收集2019年1月至2023年12月就诊于新疆医科大学第一附属医院儿科中心T1DM患儿的临床资料,包括一般情况、病程、胰岛素注射方式、糖化血红蛋白(HbA1c)等。根据HbA1c控制目标分为达标组(HbA1c<7.5%)和未达标组(HbA1c≥7.5%),采用χ2检验或者Mann-WhitneyU检验比较组间年龄、民族、病程、胰岛素注射方式等资料,采用Pearson相关系数分析相关性,通过二元Logistic回归和线性回归分析影响HbA1c达标的因素。结果514例T1DM患儿中男250例(48.6%)、女264例(51.4%),年龄10(7,12)岁,糖尿病病程2.0(0.8,3.7)年,HbA1c为9.8%±2.7%,达标组共130例(25.3%),未达标组共384例(74.7%)。两组间年龄、民族、病程、胰岛素注射方式差异均有统计学意义(均P<0.05)。HbA1c和年龄均与病程呈线性正相关(r=0.29、0.29,均P<0.05)。年龄≥10岁、病程≥5年、维吾尔族、哈萨克族是影响HbA1c达标的危险因素(OR=2.73、4.33、5.96、6.02,95%CI 1.11~6.73、1.67~11.25、3.23~10.99、3.08~11.79),使用胰岛素泵(OR=0.53,95%CI 0.33~0.87)是HbA1c达标的保护因素(均P<0.05)。结论新疆儿童T1DM血糖控制不佳。胰岛素泵使用是改善血糖控制的重要因素,与血糖控制的改善关系密切。Objective To investigate the glycemic control status and analyze its influencing factors in children with type 1 diabetes mellitus(T1DM)at a single center in Xinjiang.Methods A cross-sectional survey was conducted.The clinical data of children with T1DM who were admitted to the Pediatric Center of the First Affiliated Hospital of Xinjiang Medical University from January 2019 to December 2023 were collected,including their general information,course of disease,insulin administration method,and glycosylated hemoglobin(HbA1c)levels.According to the HbA1c target,the patients were divided into 2 groups:the achieved group(HbA1c<7.5%)and non-achieved group(HbA1c≥7.5%).Age,ethnicity,course of diabetes and insulin administration methods were compared between the 2 groups usingχ2 test or Mann-Whitney U test.The correlations were analyzed by Pearson correlation coefficient.Binary Logistic regression and linear regression were used to analyze factors influencing HbA1c target achievement.Results Among the 514 children with T1DM,250(48.6%)were males and 264(51.4%)were females,with an age of 10(7,12)years and a diabetes duration of 2.0(0.8,3.7)years.The HbA1c level was 9.8%±2.7%.There were 130 cases(25.3%)in the achieved group and 384 cases(74.7%)in the non-achieved group.There were significant differences in age,ethnicity,course of disease,and insulin administration method between the two groups(all P<0.05).Both HbA1c and age were linearly positively correlated with disease duration(r=0.29,0.29,respectively;both P<0.05).Age≥10 years,disease duration≥5 years,Uygur ethnicity,and Kazak ethnicity were identified as the risk factors for achieving the HbA1c target(OR=2.73,4.33,5.96,6.02;95%CI 1.11-6.73,1.67-11.25,3.23-10.99,3.08-11.79,respectively;all P>0.05).The use of insulin pump was a protective factor for achieving HbA1c targets(OR=0.53,95%CI 0.33-0.87,P<0.05).Conclusions Glycemic control in children with T1DM in Xinjiang is suboptimal.The use of insulin pump is a significant factor closely associated with better glycem

关 键 词：糖尿病 1型 儿童 血红蛋白A 糖基化 

分 类 号：R725.8[医药卫生—儿科]