本文選題：石河子　切入點：社區(qū)　出處：《石河子大學(xué)》2016年碩士論文

【摘要】：目的:調(diào)查石河子社區(qū)2型糖尿病患者的患病情況(包括一般人口學(xué)特征、相關(guān)病史、生活與行為方式、體測、實驗室檢查、并發(fā)癥、藥物使用情況等),了解石河子市2型糖尿病治療現(xiàn)狀,取得較全面的石河子2型糖尿病治療現(xiàn)狀的基線資料。方法:采用整群隨機抽樣方法,在石河子所轄十三個社區(qū)內(nèi)選取符合納入標(biāo)準(zhǔn)的2型糖尿病患者,采用面對面信息采集方法,填寫調(diào)查表。收集基線資料:患者一般人口學(xué)特征、相關(guān)病史、生活與行為方式、體測、藥物使用情況,并完成實驗室檢查及并發(fā)癥的篩查。并利用Epidata3.02軟件建立數(shù)據(jù)庫文件并進(jìn)行數(shù)據(jù)錄入,用SPSS17.0查錯,并進(jìn)行數(shù)據(jù)分析。結(jié)果:1、共納入研究對象655例。2、基本情況:男性285例,女性370例,平均年齡66.99±9.91歲。病程平均為9.5±7.3年。3、生活與行為方式:自我監(jiān)測血糖行為欠佳,遵醫(yī)囑服藥行為可,吸煙、飲酒行為仍存在,膳食可做到搭配合理,碳水化合物總量較高。4、體測及實驗室檢查:BMI達(dá)標(biāo)率25.03%,WHR達(dá)標(biāo)率:男性10.52%、女性6.49%,SBP達(dá)標(biāo)率72.06%,DBP達(dá)標(biāo)率69.47%,TC達(dá)標(biāo)率32.98%,HDL-C達(dá)標(biāo)率:男性73.33%、女性59.45%,LDL-C達(dá)標(biāo)率28.24%,TG達(dá)標(biāo)率57.71%,FPG達(dá)標(biāo)率47.33%,2h PG達(dá)標(biāo)率44.73%,Hb Alc達(dá)標(biāo)率51.91%。對Hb Alc的logistic多因素回歸分析:腰臀比及遵醫(yī)囑服藥行為為影響因素(P0.05)。5、并發(fā)癥篩查:視網(wǎng)膜病變者42.65%,左下肢ABI降低率8.6%,右下肢ABI降低率8.4%,輕觸覺異常者88.9%,溫涼覺異常者6.65%,左下肢震動感覺閾值平均值18.50±8.69,右下肢震動感覺閾值平均值18.05±8.02。雙下肢震動感覺閾值差異有統(tǒng)計學(xué)意義(P0.05)..6、藥物使用情況:降糖藥使用率前三位:雙胍類、α-糖苷酶抑制劑、胰島素,不良反應(yīng)前三位:低血糖反應(yīng)、胃腸道反應(yīng)、體重減輕,降壓藥物使用率前三位:CCB類、ARB類、β受體阻滯劑類。結(jié)論:1、石河子市社區(qū)T2DM患者治療方案較合理,血糖控制尚可。2、加強社區(qū)慢性病管理,建立規(guī)范的糖尿病綜合防治體系迫在眉睫。
[Abstract]:Objective: to investigate the prevalence of type 2 diabetes mellitus in Shihezi community (including general demographic characteristics, related medical history, life and behavior style, physical examination, laboratory examination, complications). In order to understand the current situation of treatment of type 2 diabetes in Shihezi City and obtain more comprehensive baseline data of treatment status of type 2 diabetes mellitus, methods: cluster random sampling method was used. In 13 communities under Shihezi's jurisdiction, type 2 diabetes patients who met the inclusion criteria were selected, and face to face information collection method was used to fill out questionnaires. Baseline data were collected: general demographic characteristics of patients, relevant medical history, life and behavior patterns. Body test, drug use, laboratory examination and screening of complications were completed. Database files were set up by Epidata3.02 software and data input was carried out. SPSS17.0 was used to check errors. Data analysis was carried out. Results: 1: 1, 655 cases. The basic condition: 285 males, 370 females, mean age 66.99 鹵9.91 years. The average course of disease was 9.5 鹵7.3 years. The life and behavior style: self monitoring of blood glucose behavior was poor, the average age was 66.99 鹵9.91 years, and the average course of disease was 9.5 鹵7.3 years. According to doctor's advice, the behavior of taking medicine, smoking and drinking still exists, and the diet can be matched reasonably. The total carbohydrate content was higher. The percentage of body test and laboratory examination was 25.03 and that of WHR was 10.52% for males, 69.47% for DBP for females, 72.06% for DBP and 32.98% for HDL-C: male 73.3333, female 59.45 LDL-C 28.2424 and FPG 57.71g. The logistic multivariate regression analysis of HB Alc showed that waist hip ratio and compliance with doctor's instructions were the influencing factors (P 0.05). Complication screening: retinopathy 42.65%, left lower extremity ABI 8.6%, right lower extremity ABI 8.4%, light tactile difference. The average of the left lower limb vibration sensation threshold was 18.50 鹵8.69, and the right lower extremity vibration sensation threshold value was 18.05 鹵8.02. The difference of the double lower limb vibration sensation threshold was statistically significant (P 0.05. 05. 6). The drug use: the first three hypoglycemic drugs were used in the first three places. : biguanidine, 偽 -glucosidase inhibitors, Insulin, the first three adverse reactions: hypoglycemia, gastrointestinal reaction, weight loss, the use of antihypertensive drugs in the first three: CCB class ARB, 尾 receptor blockers. Conclusion: 1, Shihezi community T2DM patients treatment plan is more reasonable, It is urgent to strengthen the management of chronic diseases and establish a standardized comprehensive prevention and treatment system for diabetes mellitus.
【學(xué)位授予單位】：石河子大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R587.1
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本文編號：1665033