本文選題：天津市　切入點(diǎn)：糖尿病　出處：《廣東醫(yī)學(xué)》2017年S1期

【摘要】：目的為了有助于臨床醫(yī)師更好地了解哪些降糖方案能讓患者依從性更高、更適用于天津市人群,進(jìn)行天津市糖尿病患者流行病學(xué)研究。方法選取天津市糖尿病第一鑒定中心針對(duì)天津市糖尿病人群的鑒定工作資料,共收集1 003例。發(fā)放并收回患者調(diào)查問卷、并對(duì)患者糖化血紅蛋白、糖耐量以及胰島功能檢測(cè)結(jié)果等做統(tǒng)計(jì)學(xué)分析。其中口服降糖藥患者470例(口服藥組),年齡24~82歲,平均(59.77±9.70)歲,男、女比例為1.07∶1,平均病史(5.86±5.56)年,其糖耐量、胰島功能檢測(cè)指標(biāo)為血清胰島素水平。共收集注射胰島素控制糖尿病者533例(胰島素組),年齡21~49歲,平均(59.30±10.81)歲,男、女比例為1.28∶1,平均病史(10.01±7.87)年,其糖耐量、胰島功能檢測(cè)指標(biāo)為血清C肽水平。結(jié)果糖尿病的患病率與年齡關(guān)系密切,糖尿病的患病趨勢(shì)由于這一因素將明顯加重,各年齡段人群糖化血紅蛋白水平差異無統(tǒng)計(jì)學(xué)意義(F=0.092,P=0.964)。性別因素中男女平均糖化血紅蛋白水平差異有統(tǒng)計(jì)學(xué)意義,其中男性糖化血紅蛋白水平為(7.47±0.72)%,女性為(8.20±0.81)%;口服藥組男性糖化血紅蛋白水平為(7.28±0.52)%,女性為(8.56±0.66)%,差異有統(tǒng)計(jì)學(xué)意義;胰島素組男性糖化血紅蛋白水平為(7.63±0.91)%,女性為(7.84±0.85)%,差異無統(tǒng)計(jì)學(xué)意義。患者體質(zhì)指數(shù)與糖化血紅蛋白呈正相關(guān)(r=0.074,P=0.024)。兩組不同體質(zhì)指數(shù)人群糖化血紅蛋白差異無統(tǒng)計(jì)學(xué)意義�？诜幗M470例患者總糖耐量水平差異均無統(tǒng)計(jì)學(xué)意義。各治療方案間患者糖化血紅蛋白情況差異無統(tǒng)計(jì)學(xué)意義。單純口服降糖藥組糖耐量、血清胰島素水平基本為胰島素抵抗患者,表明天津市糖尿病治療現(xiàn)狀合乎規(guī)范。結(jié)論應(yīng)用胰島素治療的患者其胰島自身分泌功能尚可,胰島素分泌尚未相對(duì)缺如,效果較滿意。糖尿病的發(fā)病呈逐漸加重的流行趨勢(shì),這與多種因素特別是社會(huì)轉(zhuǎn)型和經(jīng)濟(jì)發(fā)展有關(guān)。
[Abstract]:Objective to study the epidemiology of diabetes mellitus patients in Tianjin in order to help clinicians better understand which hypoglycemic regimen can make patients more compliant and more suitable for Tianjin population.Methods 1 003 cases of diabetes mellitus were collected from Tianjin first Diabetes Identification Center.The questionnaire was distributed and collected, and the results of glycosylated hemoglobin, glucose tolerance and islet function were analyzed statistically.Among them, 470 patients with oral hypoglycemic drugs (24 ~ 82 years old, mean 59.77 鹵9.70 years old) were given oral hypoglycemic drugs. The ratio of male to female was 1.07: 1, and the mean history was 5.86 鹵5.56 years. The glucose tolerance and islet function were measured by serum insulin level.A total of 533 patients (insulin group, age 21 to 49 years, mean 59.30 鹵10.81 years) with diabetes mellitus controlled by insulin injection were collected. The ratio of male to female was 1.28: 1, with an average history of 10.01 鹵7.87 years. The glucose tolerance and islet function were measured by serum C-peptide level.Results the prevalence rate of diabetes was closely related to age. The prevalence trend of diabetes would be aggravated obviously. There was no significant difference in the level of glycosylated hemoglobin between different age groups.There was statistically significant difference in the average glycosylated hemoglobin level between male and female, among which the male was 7.47 鹵0.72, the female was 8.20 鹵0.81, the oral drug group was 7.28 鹵0.52 and the female was 8.56 鹵0.66, the difference was statistically significant.The level of glycosylated hemoglobin in insulin group was 7.63 鹵0.91g in male and 7.84 鹵0.85 in female.There was a positive correlation between body mass index (BMI) and glycosylated hemoglobin (P 0.024).There was no significant difference in glycosylated hemoglobin between the two groups with different body mass index.There was no significant difference in total glucose tolerance in 470 patients in oral drug group.There was no significant difference in glycosylated hemoglobin among different treatment regimens.The glucose tolerance and serum insulin level in the oral hypoglycemic drug group were basically insulin resistance patients, which indicated that the current status of diabetes treatment in Tianjin was in accordance with the standard.Conclusion the islet autocrine function of the patients treated with insulin is fairly good, and the insulin secretion is not yet relatively absent, and the effect is satisfactory.The prevalence of diabetes is gradually increasing, which is related to many factors, especially social transformation and economic development.
【作者單位】： 天津市第一中心醫(yī)院內(nèi)分泌科天津醫(yī)科大學(xué)衛(wèi)生部激素與發(fā)育重點(diǎn)實(shí)驗(yàn)室;
【基金】：國家自然科學(xué)基金資助項(xiàng)目(編號(hào):31470925) 衛(wèi)生部激素與發(fā)育重點(diǎn)實(shí)驗(yàn)室開放課題代謝性疾病基礎(chǔ)與臨床協(xié)同創(chuàng)新中心科學(xué)基金項(xiàng)目(編號(hào):2014DX01) 天津市衛(wèi)生局科技基金項(xiàng)目(編號(hào)2013KZ025)
【分類號(hào)】：R587.1

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