本文選題：2型糖尿病 + 患病風(fēng)險(xiǎn)　； 參考：《蘇州大學(xué)》2015年碩士論文

【摘要】：目的描述并分析姑蘇區(qū)居民2型糖尿病患病情況、患者血糖控制情況及其影響因素和社區(qū)篩查新檢出患者的人群結(jié)構(gòu),為該區(qū)2型糖尿病的防治工作提供依據(jù)。方法采取多階段整群隨機(jī)抽樣的方法,隨機(jī)抽取姑蘇區(qū)21個(gè)社區(qū)作為調(diào)查現(xiàn)場(chǎng),將居住在調(diào)查點(diǎn)6個(gè)月以上的18周歲及以上居民為研究對(duì)象。排除使用糖皮質(zhì)激素、胰腺疾病、妊娠、1型及其他類型糖尿病、近期風(fēng)疹病毒感染史。納入統(tǒng)計(jì)12585人。由培訓(xùn)合格的調(diào)查員采用統(tǒng)一設(shè)計(jì)的病例調(diào)查表,收集調(diào)查對(duì)象的人口統(tǒng)計(jì)學(xué)信息、生活方式危險(xiǎn)因素、疾病史及血糖、腰圍等體格檢查資料。根據(jù)2型糖尿病診斷標(biāo)準(zhǔn),利用橫斷面調(diào)查的方法,計(jì)算2型糖尿病的患病率,采用單因素及多因素logistics回歸的方法分析該區(qū)人群糖尿病患病的危險(xiǎn)因素。按照《國家基本公共衛(wèi)生服務(wù)規(guī)范》定義的血糖控制,采用單因素分析的方法分析影響患者血糖控制的相關(guān)因素,計(jì)算OR及95%CI。此外,利用描述性研究的流行病學(xué)方法分析此次篩查新檢出的2型糖尿病患者的人口學(xué)特征。結(jié)果1.姑蘇區(qū)2型糖尿病患病率為9.53%(1199/12585),按照江蘇省2010年人口標(biāo)化患病率為6.54%,按照全國2010年人口標(biāo)化患病率為5.97%。2.姑蘇區(qū)居民2型糖尿病患病風(fēng)險(xiǎn)單因素分析發(fā)現(xiàn),老齡(OR=14.47,95%CI:11.46-18.28)、男性(OR=1.15,95%CI:1.02-1.30)、家族遺傳(OR=6.82,95%CI:6.01-7.74)、吸煙(OR=1.20,95%CI:1.05-1.37)、超重(不包括肥胖)(OR=1.74,95%CI:1.53-1.98)肥胖(OR=2.10,95%CI:1.74-2.54)、腹型肥胖(OR=2.49,95%CI:2.20-2.82)是2型糖尿病患病的危險(xiǎn)因素。3.姑蘇區(qū)居民2型糖尿病患病風(fēng)險(xiǎn)多因素分析發(fā)現(xiàn),年齡(OR=1.67,95%CI:1.58-1.76)、腰圍(OR=1.44,95%CI:1.23-1.69)、BMI(OR=1.13,95%CI:1.02-1.26)、2型糖尿病家族史(OR=8.81,95%CI:7.49-10.40)、高血壓病(OR=2.36,95%CI:2.04-2.74)和高脂血癥(OR=1.63,95%CI:1.33-1.99)對(duì)2型糖尿病發(fā)病存在顯著影響,故老齡、腹型肥胖、BMI≥24Kg/m2、2型糖尿病家族史、高血壓病和高脂血癥是2型糖尿病患病的危險(xiǎn)因素。4.姑蘇區(qū)2型糖尿病血糖控制不良率為34.78%(352/1012)。影響血糖控制率的主要因素是腰圍(男性≥92cm,女性≥87cm)(OR=1.82,95%CI:1.27-2.63)、運(yùn)動(dòng)量(t=2.30,P=0.022)、病程(t=-3.69,P=0.000)及治療手段(趨勢(shì)χ2=9.84,P=0.002)。5.姑蘇區(qū)2型糖尿病患者中,仍有15.60%(187/1199)的患者是通過此次調(diào)查新檢出的患者,這類人群同其他已明確診斷的患者相比,有如下特征:自己認(rèn)為健康程度不錯(cuò)、年齡集中在中年,沒有定期自身常規(guī)體檢、對(duì)周邊社區(qū)衛(wèi)生服務(wù)機(jī)構(gòu)不熟知。6.將姑蘇區(qū)合并前三區(qū)的區(qū)域標(biāo)記為A、B、C,三地2型糖尿病患病率分別為10.03%、8.94%、9.37%,三地患病率無統(tǒng)計(jì)學(xué)意義(χ2=2.14,P=0.34)。影響A區(qū)域居民2型糖尿病患病的危險(xiǎn)因素按OR值從高到低前三位依次為糖尿病家族史(OR=11.12,95%CI:8.35-14.82)、合并高血壓病(OR=2.30,95%CI:1.79-2.30)和合并高脂血癥(OR=1.66,95%CI:1.19-2.31);B區(qū)域該順位為糖尿病家族史(OR=10.07,95%CI:6.36-15.95)、合并高血壓病(OR=2.30,95%CI:1.53-3.54)和腰圍(OR=1.90,95%CI:1.22-2.95);而C區(qū)域該順位同A區(qū)域。結(jié)論1.姑蘇區(qū)2型糖尿病患病率低于江蘇省及全國水平。家族遺傳史、合并高血壓病、高脂血癥、超重與腹型肥胖及老齡是姑蘇區(qū)居民2型糖尿病的患病危險(xiǎn)因素。影響血糖控制率的主要因素是腹型肥胖、運(yùn)動(dòng)量、病程及治療手段。2.姑蘇區(qū)仍有15.60%的2型糖尿病患者被漏診,提示要加強(qiáng)中年人群糖尿病篩查的力度。3.姑蘇區(qū)不同地區(qū)2型糖尿病的患病危險(xiǎn)因素及患者血糖控制情況有所不同,應(yīng)根據(jù)實(shí)際情況,開展針對(duì)性的防控工作。
[Abstract]:Objective to describe and analyze the prevalence of type 2 diabetes in the residents of Suzhou District, the control of blood sugar and its influencing factors and the population structure of the newly detected patients in community screening, and provide the basis for the prevention and treatment of type 2 diabetes in this area. Methods 21 communities in the Suzhou District were randomly selected as the investigation site. To exclude the use of glucocorticoid, pancreatic disease, pregnancy, type 1 and other types of diabetes, and the history of recent rubella virus infection. 12585 people were included in the survey by a qualified investigator trained by the trained investigators to collect the population of the respondents. Study information, life style risk factors, disease history and blood sugar, waist circumference and other physical examination data. According to the diagnostic standard of type 2 diabetes, the prevalence rate of type 2 diabetes was calculated by cross-sectional survey. The risk factors of diabetes in the population were analyzed by single factor and multiple factor logistics regression. A single factor analysis was used to analyze the related factors affecting patients' blood glucose control, OR and 95%CI. were calculated by the method of single factor analysis, and the demographic characteristics of the newly detected type 2 diabetic patients were analyzed by descriptive epidemiological methods. Results 1. the prevalence rate of type 2 diabetes in the District of Suzhou was found to be 9.53% (1199/12585), according to the population standardized prevalence rate of 6.54% in Jiangsu Province in 2010, according to the single factor analysis on the risk of type 2 diabetes in the residents of 5.97%.2. in 2010, the age (OR=14.47,95%CI:11.46-18.28), the male (OR=1.15,95% CI:1.02-1.30), the family heredity (OR=6.82,95%CI:6.01-7.74), and smoking (OR=1) were found. .20,95%CI:1.05-1.37), overweight (not including obesity) (obesity) (OR=1.74,95%CI:1.53-1.98) obesity (OR=2.10,95%CI:1.74-2.54), abdominal obesity (OR=2.49,95%CI:2.20-2.82) is a risk factor for type 2 diabetes mellitus, the multifactor analysis of the risk of type 2 diabetes in the residents of the.3. District of Suzhou, the age (OR=1.67,95%CI:1.58-1.76), and the waistline (OR=1.44,95%CI:1.23-1) .69), BMI (OR=1.13,95%CI:1.02-1.26), family history of type 2 diabetes (OR=8.81,95%CI:7.49-10.40), hypertension (OR=2.36,95%CI:2.04-2.74) and hyperlipidemia (OR=1.63,95%CI:1.33-1.99) have a significant impact on the onset of type 2 diabetes, so aging, abdominal obesity, family history of BMI more than 24Kg/m2,2, hypertension and hyperlipidemia are type 2 sugar. The risk factor of urinary disease in.4. was 34.78% (352/1012). The main factors affecting the control rate of blood sugar were waist circumference (male > 92cm, female > 87cm) (OR=1.82,95%CI:1.27-2.63), exercise (t=2.30, P=0.022), t= -3.69, P=0.000, and treatment methods (trend Chi 2=9.84, P=0.002) 2 type of caunu District Among the patients with diabetes, 15.60% (187/1199) of the patients were newly detected by the survey. Compared with other patients who had been diagnosed, the group had the following features: good health, age in middle age, regular routine examination, and no knowledge of.6. in the surrounding community health services. The prevalence of type 2 diabetes in the first three areas was A, B, C, and three, and the prevalence rate of type 2 diabetes was 10.03%, 8.94%, 9.37%, and three had no statistical significance (x 2=2.14, P=0.34). The risk factors affecting the prevalence of type 2 diabetes in the A region were followed by the family history of diabetes (OR=11.12,95%CI:8.35-14.82) in sequence of the OR value from the high to the low in the first three, with the combination of hypertension. Disease (OR=2.30,95%CI:1.79-2.30) and hyperlipidemia (OR=1.66,95%CI:1.19-2.31); the B region is a family history of diabetes (OR=10.07,95%CI:6.36-15.95), combined with hypertension (OR=2.30,95%CI:1.53-3.54) and waist circumference (OR=1.90,95%CI:1.22-2.95), while the C region is the same as A area. Conclusion the prevalence rate of type 2 diabetes in 1. Suzhou district is lower than that of Jiangsu. Provincial and national levels. Family history of heredity, hypertension, hyperlipidemia, overweight and abdominal obesity and aging are the risk factors for type 2 diabetes in the District of Suzhou. The main factors affecting the control rate of blood sugar are abdominal obesity, exercise, course of disease and treatment, and 15.60% of patients with type 2 diabetes still have missed diagnosis in.2.'s district. To strengthen the strength of diabetes screening in middle-aged people.3., the risk factors of type 2 diabetes in different areas and the control of blood glucose in different areas of the District of Suzhou are different. The prevention and control work should be carried out according to the actual situation.
【學(xué)位授予單位】：蘇州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R587.1

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