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目的了解浙江省嘉善县农村地区2型糖尿病(T2DM)患者10年卒中发病的风险情况,为不同风险患者科学化管理提供依据。方法于2015年6月至2016年12月,在浙江省嘉善县9个乡镇中进行随机抽样,以被抽取行政村中在浙江省慢性病监测信息系统数据库中登记的嘉善籍且年龄≥54岁的T2DM患者为调查对象。按性别分组,再按年龄、病程、糖化血红蛋白(HbA_(1C))水平进行分层,用SPSS 17.0统计软件包进行t检验、方差分析、秩和检验和χ~2检验,采用多元有序回归分析进行相关因素分析。结果 630例T2DM患者10年卒中发病风险概率为16.37%(9.00%~19.00%);低危占12.71%,中危占16.82%,高危占70.47%。男性组的吸烟率、饮酒率、舒张压(DBP)、血尿酸(SUA)、HbA_(1C)、合并高血压疾病比例、合并其他心血管疾病比例均高于女性组,而病程、总胆固醇(TC)、甘油三酯(TG)低于女性组,差异均有统计学意义(P<0.05,P<0.01);男性和女性的10年卒中发病风险概率均随着年龄的增长而升高,男性55~61、62~67、68~72岁组10年卒中发病风险概率高于女性,差异均有统计学意义(P<0.05,P<0.01)。病程为0~3.0和5.1~10.0年组不同性别间比较,10年卒中发病风险概率差异均有统计学意义(P<0.05)。HbA_(1C)水平为6.4%~7.5%、7.6%~12.5%的不同性别间比较,10年卒中发病风险概率差异均有统计学意义(P<0.05,P<0.01)。多元有序回归分析结果显示,病程(β=0.007,P=0.256)、HbA_(1C)(β=-0.010,P=0.081)与T2DM患者10年卒中发病风险概率无相关性(P>0.05)。结论浙江省嘉善县农村地区T2DM患者10年卒中发病风险以高危者居多,男性高于女性,且患者年龄越大风险越高。
Objective To understand the 10-year risk of stroke in type 2 diabetes mellitus (T2DM) in rural areas of Jiashan County, Zhejiang Province, and to provide evidence for the scientific management of patients with different risks. Methods From June 2015 to December 2016, random samples were collected from 9 towns and villages in Jiashan County, Zhejiang Province. The samples were collected from Jiashan School of Chronic Disease Surveillance and Information System Database of Zhejiang Province and were aged 54 or above T2DM patients for the survey. The patients were divided into different groups according to their sex, age, course of disease and HbA_ (1C) levels. SPSS 17.0 software package was used for t test, ANOVA, rank sum test and Chi-square test. Analysis of relevant factors. Results The incidence of 10-year risk of stroke in 630 T2DM patients was 16.37% (9.00% -19.00%), 12.71% in low risk, 16.82% in moderate risk and 70.47% in high risk. The smoking rate, drinking rate, DBP, SUA, HbA 1c, the proportion of hypertension with hypertension and other cardiovascular diseases in the male group were higher than those in the female group. The duration of disease, total cholesterol TC and triglyceride were lower than those in the female group (P <0.05, P <0.01). The incidence of 10-year risk of stroke in both men and women increased with age, The incidence of 10-year risk of stroke in men 55-61,62-67,68-72 years old group was higher than that in women, the difference was statistically significant (P <0.05, P <0.01). Duration of 0 to 3.0 and 5.1 to 10.0 years of different genders, 10-year risk of stroke risk differences were statistically significant (P <0.05). HbA_ (1C) levels were 6.4% ~ 7.5%, 7.6% ~ 12.5% in different gender, 10-year risk of stroke risk difference was statistically significant (P <0.05, P <0.01). Multivariate regression analysis showed no correlation between the duration of 10-year risk of stroke and the incidence of stroke (P> 0.05) . Conclusion The prevalence of stroke in 10-year T2DM patients in rural areas of Jiashan County, Zhejiang Province is higher than that of women at risk, and the risk of T2DM patients is higher in older men.