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目的了解门诊2型糖尿病患者合并代谢综合征(MS)的检出率、整体治疗水平和控制达标情况,并分析其影响因素。方法 2009年6月～2009年12月连续收集679例门诊2型糖尿病患者的临床资料,包括人口学、体格检查、生化指标等,对不同专科的内科住院医师诊断和处置MS的水平进行分析。结果门诊2型糖尿病患者合并MS者占62.3%,女性为64.5%,男性为60.2%,>50岁的女性检出率明显高于男性;合并异常组分中肥胖比率最高(77.2%),其次是高血压(49.0%)、血脂紊乱(46.5%)。90.2%的糖尿病患者伴发其他代谢异常组分。Logistic回归分析发现检出率与代谢异常家族史、女性成正相关,OR值分别为1.48和1.92(P<0.05),而与运动治疗成负相关,OR值为0.68(P<0.05)。糖尿病患者中血糖、血压、血脂的药物治疗率分别为70.3%,73.9%和23.1%。门诊患者糖化血红蛋白、血压和血脂4项达标率分别为31.8%、27.0%和12.6%。接受过糖尿病教育的患者各指标达标率均高于未接受教育的患者。门诊内分泌专科医师对糖尿病之外MS其他相关各项代谢异常的诊断(诊断率40%～50%)和处置(处置率20%～30%)水平均低。结论门诊2型糖尿病患者MS检出率较高,整体治疗水平和达标情况较差,开展健康教育,尤须加强综合管理并提高门诊医生的处置水平以促进各代谢异常组分达标。
Objective To investigate the detection rate, overall treatment level and control standard of metabolic syndrome (MS) in outpatients with type 2 diabetes mellitus and to analyze the influencing factors. Methods From June 2009 to December 2009, the clinical data of 679 outpatients with type 2 diabetes mellitus, including demographics, physical examinations and biochemical indexes, were collected continuously to analyze the diagnosis and treatment of MS in medical specialties of different specialties. Results Outpatients with type 2 diabetes mellitus (MS) accounted for 62.3%, women 64.5%, men 60.2%, women> 50 years old had significantly higher detection rate than men. The rate of obesity was the highest among all the patients (77.2%), followed by Hypertension (49.0%), dyslipidemia (46.5%). 90.2% of diabetic patients with other metabolic abnormalities components. The Logistic regression analysis showed that the detection rate was positively correlated with the family history and the female with abnormal metabolic rate. The OR values were 1.48 and 1.92 respectively (P <0.05), but negatively correlated with exercise therapy. The odds ratio was 0.68 (P <0.05). Diabetes patients with blood glucose, blood pressure, blood lipid drug treatment rates were 70.3%, 73.9% and 23.1%. Outpatients with glycosylated hemoglobin, blood pressure and blood lipid compliance rate of 4 were 31.8%, 27.0% and 12.6%. Patients who received diabetes education had higher compliance rates than non-educated patients. Outpatient endocrinologists diagnosed metabolic abnormalities (diagnosis rate 40% -50%) and disposition (treatment rate 20% -30%) related to MS other than diabetes mellitus with low level. Conclusions The detection rate of MS in outpatients with type 2 diabetes mellitus is high, and the overall level of treatment and compliance is poor. Health education should be carried out. In particular, it is necessary to strengthen integrated management and improve the level of outpatient treatment in order to promote compliance of various metabolic abnormalities components.