论文部分内容阅读
目的了解社区2型糖尿病患者规范管理的现况及其对血糖控制的影响,为提高社区2型糖尿病患者的血糖控制水平提供依据。方法于2014年10-12月在山东省和江苏省共20个社区卫生服务机构的居民健康档案中随机抽取2型糖尿病患者进行人口学特征及规范化管理等方面的问卷调查,同时测量身高、体重和血压。不同组别规范管理率的比较采用χ~2检验,血糖控制的影响因素分析采用logistic回归分析。结果共收回有效问卷1 462份,城市患者727例(49.7%),农村患者735例(50.3%)。28.5%的社区2型糖尿病患者得到规范管理,农村患者规范管理率(37.1%)显著高于城市患者(19.8%),差异有统计学意义(χ~2=53.87,P<0.01)。规范管理的患者血糖控制达标率为46.0%,显著高于未规范管理患者(38.8%),差异有统计学意义(χ~2=6.55,P<0.05)。多因素logistic回归分析显示,居住城市、体重控制、血压控制以及规范管理是血糖控制的保护因素(OR值分别为0.56、0.67、0.78和0.65),年龄<55岁、病程≥10年是血糖控制的不利因素(OR值分别为2.07、1.94)。结论社区2型糖尿病患者的规范管理率还有待提高,规范管理有助于提高患者的血糖控制。
Objective To understand the current status of standardized management of patients with type 2 diabetes in community and its effect on blood sugar control, and to provide basis for improving the level of blood sugar control in patients with type 2 diabetes in community. Methods A total of 20 community health service agencies in Shandong Province and Jiangsu Province from October to December were randomly selected from the health records of patients with type 2 diabetes demographic characteristics and standardized management and other aspects of the questionnaire survey while measuring height and weight And blood pressure. Different groups of standardized management rate comparison using χ ~ 2 test, blood glucose control factors analyzed using logistic regression analysis. Results A total of 1 462 valid questionnaires were retrieved, including 727 urban patients (49.7%) and 735 rural residents (50.3%). 28.5% of patients with community type 2 diabetes were regulated. The standardized management rate of rural patients was significantly higher than that of urban patients (19.1% vs 37.1%, χ ~ 2 = 53.87, P <0.01). The standardized rate of glycemic control was 46.0% in patients under standard management, which was significantly higher than that in unmanaged patients (38.8%) (χ ~ 2 = 6.55, P <0.05). Multivariate logistic regression analysis showed that urban residents, weight control, blood pressure control and standardized management were the protective factors of glycemic control (OR = 0.56,0.67,0.78 and 0.65, respectively), age <55 and duration> 10 years were control of blood glucose (OR = 2.07 and 1.94, respectively). Conclusion The standardized management rate of community type 2 diabetes patients needs to be improved, and standardized management can help to improve the patients’ blood sugar control.