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目的:了解蚌埠地区1980年糖尿病(DM)普查出的168例糖代谢异常患者(144例T2DM、24例IGT)25年临床转归。方法:根据患者病情不同,对144例T2DM和24例IGT患者分别给予生活方式及药物干预,25年间对114例T2DM患者及22例IGT各项临床指标进行随访。结果:114例T2DM中4例患者逆转为IGT;心脑血管、肾病/视网膜病变患病率分别为57.0%、60.5%;25年病死率为70.2%(80/114)。主要死亡原因依次为心脑血管病、多脏器功能衰竭、慢性肾功能不全、恶性肿瘤。24例IGT患者失访2例,18.2%发展成DM,年转变率为0.73%,36.4%仍为IGT,45.5%转为NGT。结论:T2DM慢性并发症以大血管和微血管病变患病率最高,且随病程延长增加;综合干预可有效降低IGT向DM转化。
OBJECTIVE: To understand the 25-year clinical outcomes of 168 patients with abnormal glucose metabolism (144 T2DM and 24 IGT) diagnosed by diabetes (DM) in 1980 in Bengbu. Methods: According to the patient’s condition, 144 patients with T2DM and 24 patients with IGT were given life-style and drug intervention. Clinical data of 114 T2DM patients and 22 patients with IGT were followed up for 25 years. Results: Four of the 114 T2DM patients were reversed to IGT. The prevalence rates of cardiovascular and renal diseases / retinopathy were 57.0% and 60.5%, respectively. The 25-year mortality rate was 70.2% (80/114). The main causes of death were cardiovascular and cerebrovascular diseases, multiple organ failure, chronic renal insufficiency, and malignant tumors. Twenty-four patients with IGT were lost to follow-up in 2 cases and 18.2% developed DM. The annual rate of change was 0.73%, 36.4% remained IGT and 45.5% changed to NGT. Conclusion: The prevalence of chronic vascular complications in T2DM patients with macrovascular and microvascular diseases is the highest and increases with the duration of T2DM. Comprehensive intervention can effectively reduce the conversion of IGT to DM.