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目的了解北京地区2型糖尿病慢性并发症和合并症的情况。方法由中华医学会北京分会老年专业委员会组织调查本市36家一、二、三级医院住院和门诊已确诊的2型糖尿病患者2077例,男1061例(51%),女1016例(49%),平均年龄(62±12)岁,平均糖尿病病程(8.3±6.6)年,采用统一的方法回顾病史及访谈填写调查表格,统一的体检及测量方法。取空腹8h以上静脉血测定血清空腹血糖、总胆固醇、低密度脂蛋-胆固醇、甘油三酯、高密度脂蛋白-胆固醇、丙氨酸转氨酶、天冬氨酸转氨酶、尿素氮、血肌酐等生化指标,取指尖血测定餐后2h血糖,糖化血红蛋白A1c。行尿常规检查,测定尿微量白蛋白排泄率,行腹部、下肢动脉B超检查,眼科医师按统一标准判断眼底病变。结果2型糖尿病各并发症或合并症发生率分别为高血压60.8%,冠心病26.5%,脑梗死14.5%,脑出血1.7%。下肢血管病变16.4%。糖尿病神经病变21.8%,糖尿病足14.5%,糖尿病肾病23.7%(其中微量白蛋白尿11.3%,临床蛋白尿10%,血清肌酐升高5.2%)。糖尿病眼底病变19.3%,血脂异常52.2%。合并疾病:脂肪肝39.1%,胆石症8.9%,足背动脉波动消失或减弱右侧16.7%、左侧18.2%,心电图异常30.6%,胸片异常9%,眼底异常28.4%。结论2077例2型糖尿病的相关调查提示一些慢性并发症患病率已达到相当高的水平。
Objective To understand the chronic complications and complications of type 2 diabetes in Beijing. Methods A total of 2077 patients with type 2 diabetes diagnosed as inpatient and outpatient clinics in 36 first, second and third level hospitals in our city were investigated by the Committee of Gerontology Professional Committee of Beijing Branch of Chinese Medical Association. Among them, 1061 (51%) were male and 1016 (49% ), Mean age (62 ± 12) years and average duration of diabetes (8.3 ± 6.6) years. The methods of reviewing medical history and interview were completed by using a unified method. Serum fasting blood glucose, total cholesterol, low density lipoprotein-cholesterol, triglyceride, high density lipoprotein-cholesterol, alanine aminotransferase, aspartate aminotransferase, urea nitrogen and serum creatinine Indicators, finger fingertips blood 2h after meal blood glucose, glycosylated hemoglobin A1c. Urine routine examination, determination of urinary albumin excretion rate, abdomen, lower extremity artery B-ultrasound, ophthalmologists according to a uniform standard to determine retinal lesions. Results The incidence of complication or complications of type 2 diabetes were 60.8% of hypertension, 26.5% of coronary heart disease, 14.5% of cerebral infarction and 1.7% of cerebral hemorrhage. Lower extremity vascular lesions 16.4%. Diabetic neuropathy 21.8%, diabetic foot 14.5%, diabetic nephropathy 23.7% (microalbuminuria 11.3%, clinical proteinuria 10%, serum creatinine increased 5.2%). Diabetic retinopathy 19.3%, dyslipidemia 52.2%. Combined diseases: fatty liver 39.1%, cholelithiasis 8.9%, disappearance or weakening of the dorsalis pedis artery right 16.7%, left 18.2%, electrocardiogram abnormalities 30.6%, chest X-ray abnormalities 9%, fundus anomalies 28.4%. Conclusion 2077 cases of type 2 diabetes related investigations suggest that the prevalence of some chronic complications has reached a very high level.