本文選題：糖調(diào)節(jié)異常 + 平衡功能�。� 參考：《首都醫(yī)科大學(xué)》2017年碩士論文

【摘要】：研究背景糖尿病(diabetes mellitus,DM)是由遺傳和環(huán)境因素共同引起的一組以糖代謝紊亂為主要表現(xiàn)的臨床綜合征。2013年寧光教授的流調(diào)數(shù)據(jù)中我國(guó)糖尿病的患病率為11.6%,糖調(diào)節(jié)異常的發(fā)生率高達(dá)50.1%[1]。國(guó)內(nèi)外大量研究表明糖尿病患者發(fā)生跌倒風(fēng)險(xiǎn)明顯增高[2,3],其治療及護(hù)理需要更多時(shí)間及經(jīng)濟(jì)方面投入,嚴(yán)重影響患者及其家人生活質(zhì)量,增加家庭及社會(huì)醫(yī)療負(fù)擔(dān),2012年美國(guó)糖尿病學(xué)會(huì)(American Diabetes Association,ADA)指南[4]和2013年美國(guó)老年學(xué)會(huì)(Gerontological Society of American,AGS)指南[5]中均建議醫(yī)護(hù)人員關(guān)注糖尿病患者跌倒的預(yù)防和治療。跌倒的發(fā)生與很多因素有關(guān),而最重要的為平衡能力受損[6]。因此了解糖尿病前期患者平衡功能狀況,從而對(duì)高危人群跌倒風(fēng)險(xiǎn)進(jìn)行早期評(píng)估尤為重要。目前相關(guān)研究較少。本研究將應(yīng)用平衡儀對(duì)糖調(diào)節(jié)異常(Impaired Glucose Regulation,IGR)患者進(jìn)行平衡功能檢查,分析IGR患者的平衡功能特點(diǎn),為糖尿病前期階段跌倒高風(fēng)險(xiǎn)人群的早發(fā)現(xiàn)、早預(yù)防提供依據(jù)。目的通過(guò)平衡功能測(cè)試,了解糖調(diào)節(jié)異常人群平衡功能狀況。方法1、通過(guò)文獻(xiàn)檢索、專家論證、設(shè)定入排標(biāo)準(zhǔn)、技術(shù)路線和調(diào)查問(wèn)卷,調(diào)查問(wèn)卷見附件1。2、根據(jù)問(wèn)卷調(diào)查、查體、化驗(yàn)檢查納入年齡≤65歲既往無(wú)糖尿病病史的受試者,排除耳源性眩暈、前庭神經(jīng)炎、嚴(yán)重視覺障礙及視野缺損、顱腦疾患、下肢畸形、新發(fā)骨折等影響姿態(tài)平衡的疾病。3、通過(guò)OGTT試驗(yàn)選取IGR患者29例(男9例,女20例,平均年齡52.93±7.53歲),對(duì)照組選取年齡、性別匹配糖耐量正常的同期健康體檢者共27例(男7例,女20例,平均年齡49.59±7.60歲)。4、收集受試者一般基線資料(包括年齡、性別、既往史、跌倒史等),及內(nèi)分泌相關(guān)化驗(yàn)結(jié)果(如糖化血紅蛋白、血脂、甲狀腺功能等),并對(duì)受試者進(jìn)行身高、體重測(cè)量。5、平衡能力測(cè)試。應(yīng)用的設(shè)備為synapsys平衡儀,通過(guò)感覺結(jié)構(gòu)測(cè)試(sensory organization test,SOT)對(duì)本體覺、前庭覺及視覺在維持姿勢(shì)穩(wěn)定中的貢獻(xiàn)度進(jìn)行定量分析。對(duì)比分析兩組的感覺結(jié)構(gòu)測(cè)試評(píng)分、壓力中心移動(dòng)面積(Surface of the Statokinesigram,SSKG)、前后及左右方向壓力中心最大位移(Anteroposterior and Medio-Lateral Maximum amplitudes)來(lái)研究IGR患者平衡功能特點(diǎn)。6、數(shù)據(jù)處理:使用SPSS21.0進(jìn)行統(tǒng)計(jì)學(xué)分析。計(jì)量資料符合正態(tài)分布的數(shù)據(jù)用均數(shù)±標(biāo)準(zhǔn)差表示,非正態(tài)分布的計(jì)量數(shù)據(jù)經(jīng)對(duì)數(shù)轉(zhuǎn)換后呈正態(tài)分布以幾何均數(shù)±標(biāo)準(zhǔn)差表示。對(duì)于經(jīng)對(duì)數(shù)轉(zhuǎn)換后仍為非正態(tài)分布的數(shù)據(jù)則以中位數(shù)[第一四分位數(shù),第三四分位數(shù)]表示。兩組間均數(shù)比較符合正態(tài)分布的采用兩獨(dú)立樣本t檢驗(yàn),不符合正態(tài)分布的采用Mann-Whitney u檢驗(yàn),率的比較采用卡方檢驗(yàn)。所有統(tǒng)計(jì)檢驗(yàn)均采用雙側(cè)檢驗(yàn),顯著性水平選取P0.05。結(jié)果1、IGR組在睜眼站立于海綿墊時(shí)、閉眼站立于海綿墊時(shí)及站立于海綿墊同時(shí)受到視覺干擾情況下,SSKG均大于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);2、IGR組在睜眼站立于海綿墊時(shí)左右方向最大位移大于對(duì)照組,在閉眼站立于海綿墊時(shí)前后方向最大位移大于對(duì)照組,在站立于海綿墊同時(shí)受到視覺干擾時(shí)前后及左右方向最大位移均大于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);3、SOT結(jié)果:IGR組左右方向前庭覺評(píng)分、前后及左右方向綜合評(píng)分小于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論糖調(diào)節(jié)異�；颊咂胶饽芰^正常人下降,表現(xiàn)在:1、本體覺受到干擾情況下維持姿態(tài)穩(wěn)定的能力較正常人下降;2、其依賴前庭覺維持姿態(tài)平衡的能力較正常人有所減弱。
[Abstract]:Research background diabetes (diabetes mellitus, DM) is a group of genetic and environmental factors co induced by a group of clinical syndromes with glucose metabolism disorder as the main manifestation of.2013 years Professor Ning Guang's flow data, the prevalence rate of diabetes in China is 11.6%, the incidence of abnormal glucose regulation is up to 50.1%[1]. at home and abroad a large number of studies show that diabetes mellitus The risk of falling falls significantly increased [2,3], and its treatment and nursing needs more time and economic input, seriously affecting the quality of life of the patients and their families, and increasing the burden on family and social health. In 2012, the American Diabetes Society (American Diabetes Association, ADA) refers to the South [4] and the 2013 American Society for aging (Gerontological Society o). The f American, AGS) guide [5] recommends that medical staff pay attention to the prevention and treatment of fall in diabetic patients. The occurrence of falls is related to many factors, and the most important is the balance of impaired [6].. Therefore, it is particularly important to understand the balance function of prediabetes patients so as to make early assessment of the risk of falling in high-risk groups. The study will be less. This study will use balance instrument to check the balance function of patients with Impaired Glucose Regulation (IGR), analyze the balance function of IGR patients and provide the basis for early detection and early prevention of high risk people who have fallen in the early stage of diabetes. Method 1. Through literature search, expert demonstration, set up standard, technical route and questionnaire, the questionnaire was found in Annex 1.2. According to the questionnaire survey, examination and test, the subjects who were less than 65 years old without the history of diabetes were excluded from ear origin vertigo, vestibule neuritis, severe visual impairment and visual field defect. .3, 29 cases of IGR patients (9 males, 20 females, average age 52.93 + 7.53 years old) were selected by OGTT test for craniocerebral disease, lower limb deformity and new fracture. The control group was selected for age, 27 cases (7 men, 20 women, 49.59 + 7.60 years old, average age 49.59 + 7.60 years) were selected for the control group, and the subjects were collected in the same period of healthy physical examination. General baseline data (including age, sex, past history, fall history, etc.), and endocrine related testing results (such as glycosylated hemoglobin, blood lipid, thyroid function, etc.), and the subjects were stature, weight measurement.5, balance test. The applied equipment was synapsys balance, sensory organization test, SOT) Quantitative analysis of the contribution of the sense of proprioception, vestibule and vision in maintaining the stability of the posture. Comparative analysis of two groups of sensory structure test scores, pressure center mobile area (Surface of the Statokinesigram, SSKG), the maximum displacement of the front and left pressure center (Anteroposterior and Medio-Lateral Maximum amplitudes) to study The balance function of IGR patients.6, data processing: statistical analysis using SPSS21.0. The data of measurement data conforming to normal distribution are represented by mean number of mean deviation, and the Cheng Zhengtai distribution of non normal distribution is expressed as a geometric mean difference after logarithmic conversion. For the data that is still a non normal distribution after the logarithmic transformation, The median number [first four quantiles, three or four digits] was expressed. The average number of two groups was compared with the normal distribution with two independent samples t test. The Mann-Whitney U test was not consistent with the normal distribution. The ratio of the rate was compared to the chi square test. All the statistical tests were both tested by bilateral test, the significant level was 1 of the P0.05. results, and the IGR group was open. When the eye station was standing on the sponge pad, when the closed eye station was standing on the sponge pad and standing on the sponge pad at the same time, the SSKG was larger than the control group, and the difference was statistically significant (P0.05). 2, the maximum displacement in the left and right direction in the group IGR was larger than the control group when the eye opening station was standing on the sponge pad, and the maximum displacement in the front and back of the closed eye station was larger than the sponge pad. In the control group, the maximum displacement in front and back and left and right direction were greater than that of the control group at the time of visual interference. The difference was statistically significant (P0.05); 3, SOT results: the score of the vestibular sense in the left and right direction of group IGR was less than that of the control group, the difference was statistically significant (P0.05). Conclusion the patients with abnormal glucose regulation were statistically significant. The ability of balance was lower than that of the normal person. 1, the ability to maintain attitude stability was lower than that of the normal person, and 2, the ability to maintain the balance of the vestibule was weaker than that of the normal person.

【學(xué)位授予單位】：首都醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R587.1

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 程冬梅;邵黎明;范利華;陳芳;孫婧;;下肢損傷者姿勢(shì)誘發(fā)反射下的動(dòng)態(tài)姿勢(shì)圖分析[J];法醫(yī)學(xué)雜志;2015年06期

2 黃小兵;劉博;孫敬武;李希平;龔敬;段金萍;趙小燕;周迎生;魏永祥;;2型糖尿病患者平衡功能的分析與評(píng)價(jià)[J];臨床耳鼻咽喉頭頸外科雜志;2016年01期

3 沈曄;白姣姣;孫皎;潘習(xí);盧湘;紀(jì)麗;臧嫻;王明華;儲(chǔ)英;;老年糖尿病周圍神經(jīng)病變患者平衡功能的調(diào)查分析[J];老年醫(yī)學(xué)與保健;2015年05期

4 韓俊;羅志增;張啟忠;;基于靜態(tài)姿勢(shì)圖的人體平衡功能檢測(cè)與評(píng)估[J];中國(guó)生物醫(yī)學(xué)工程學(xué)報(bào);2014年05期

5 袁金風(fēng);張秋霞;陸阿明;;閉眼單腳站立方法在體質(zhì)測(cè)試中的應(yīng)用[J];中國(guó)組織工程研究;2013年33期

6 周蕓;劉博;;糖尿病患者平衡功能障礙的發(fā)生機(jī)制[J];中華耳科學(xué)雜志;2011年04期

7 周曉蓉;范利華;楊小萍;;顱腦損傷后動(dòng)態(tài)姿勢(shì)平衡評(píng)估[J];法醫(yī)學(xué)雜志;2010年06期

8 朱敏;閆雅鳳;甕長(zhǎng)水;;老年人主動(dòng)性靜態(tài)和動(dòng)態(tài)平衡測(cè)試的重測(cè)信度:Korebalance平衡測(cè)量系統(tǒng)[J];中國(guó)康復(fù)理論與實(shí)踐;2010年06期

9 關(guān)慶捷;孫秀珍;劉t，

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