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目的了解常熟市2型糖尿病(T2DM)患者血糖控制情况,初步探索患者血糖控制的影响因素,为采取有效干预措施提供参考依据。方法调查时间为2013年10月-2014年2月,采用多阶段分层整群抽样的方法,对常熟市纳入基本公共卫生服务的2型糖尿病患者10 246人进行糖尿病问卷调查、糖尿病患者身体测量和空腹血糖、糖化血红蛋白(Hb A1c)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)的实验室指标检测。以Hb A1c是否达标作为因变量,进行非条件logistic回归分析,将单因素非条件logistic回归分析中P<0.1的影响因素纳入多因素分析,用逐步回归法进行多因素非条件logistic回归分析,探讨血糖控制的影响因素。结果获得10 238名2型糖尿病患者的完整数据,常熟市2型糖尿病患者糖化血红蛋白(Hb A1c)平均值为(7.6±1.6)%,控制未达标者(Hb A1c≥7%)占59.2%。单因素非条件logistic回归分析结果显示性别、地区、文化程度、BMI、腰围、血脂、吸烟、饮酒对Hb Alc的影响有统计学意义(P<0.01),多因素非条件logistic回归分析结果显示,地区(农村/城市OR=1.359,95%CI:1.252~1.475,P<0.001)、吸烟(OR=1.474,95%CI:1.327~1.638,P<0.001)、血脂异常(OR=1.240,95%CI:1.143~1.346,P<0.001)、腰围(中心性肥胖OR=1.294,95%CI:1.192~1.405,P<0.001)、文化程度(以未接受正规教育为参照,小学OR=0.825,95%CI:0.741~0.920,P<0.001;初中及以上OR=0.895,95%CI:0.808~0.991,P<0.001)是血糖控制的独立影响因素。结论常熟市2型糖尿病患者血糖控制情况不佳,血糖控制状况受地区、吸烟、血脂异常、中心性肥胖和文化程度的影响,应积极开展综合措施控制血糖和糖尿病并发症的发生。
Objective To understand the glycemic control in type 2 diabetes mellitus (T2DM) in Changshu city and to explore the influencing factors of glycemic control in patients with T2DM, so as to provide a reference for effective interventions. Methods The survey was conducted from October 2013 to February 2014. A total of 10 246 people with type 2 diabetes who were included in the basic public health service in Changshu City were surveyed for diabetes by multi-stage stratified cluster sampling method. The body measurements of diabetic patients And laboratory test of fasting blood glucose, Hb A1c, TG, HDL-C, LDL-C, TC . The Hb A1c compliance as a dependent variable, non-conditional logistic regression analysis, univariate non-conditional logistic regression analysis of factors P <0.1 into multivariate analysis, using stepwise regression analysis of multivariate non-conditional logistic regression analysis Influencing factors of glycemic control. Results The complete data of 10 238 type 2 diabetic patients were obtained. The average Hb A1c in type 2 diabetic patients was (7.6 ± 1.6)% in Changshu city, and 59.2% was not controlled (Hb A1c ≥ 7%). The results of univariate logistic regression analysis showed that the influence of gender, region, educational level, BMI, waist circumference, lipids, smoking and drinking on Hb Alc were statistically significant (P <0.01). The multivariate non-conditional logistic regression analysis showed that, (OR = 1.474, 95% CI: 1.327-1.638, P <0.001), and dyslipidemia (OR = 1.240, 95% CI: 1.359, 95% CI: 1.252-1.475, P <0.001) (OR = 1.294, 95% CI: 1.192-1.405, P <0.001), educational level (no education for all, OR = 0.825,95 % CI: 0.741 ~ 0.920, P <0.001; junior high school and above OR = 0.895,95% CI: 0.808 ~ 0.991, P <0.001) were independent influencing factors of glycemic control. Conclusion Patients with type 2 diabetes mellitus in Changshu City have poor glycemic control and their glycemic control status is affected by the region, smoking, dyslipidemia, central obesity and education level. Comprehensive measures should be taken to control the occurrence of complications of blood sugar and diabetes.