文章摘要
邓茜,张梅,黄正京,李镒冲,王丽敏.全国疾病监测点35岁及以上糖尿病患者管理现状研究[J].中华流行病学杂志,2016,37(9):1191-1195
全国疾病监测点35岁及以上糖尿病患者管理现状研究
Management of diabetes patients aged ≥35 years in disease surveillance areas in China
收稿日期:2016-05-12  出版日期:2016-09-14
DOI:10.3760/cma.j.issn.0254-6450.2016.09.002
中文关键词: 糖尿病  疾病管理  血糖
英文关键词: Diabetes  Disease management  Blood glucose
基金项目:
作者单位E-mail
邓茜 100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心  
张梅 100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心  
黄正京 100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心  
李镒冲 100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心  
王丽敏 100050 北京, 中国疾病预防控制中心慢性非传染性疾病预防控制中心 wlm65@126.com 
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中文摘要:
      目的 通过分析全国横断面调查数据,对中国≥35岁居民的糖尿病社区管理现状和血糖控制的情况进行评价。方法 在2013-2014年中国慢性病及其危险因素监测的所有调查对象中,通过整群抽样的方法选取≥35岁且被乡镇(社区)级或以上医院诊断为糖尿病的患者作为研究对象。应用问卷收集调查对象的一般人口学特征、参加社区糖尿病管理、糖尿病治疗及控制的情况。测定调查对象的FPG和服糖后2 h血糖。采用复杂加权计算调查对象不同特征的率及其95% CI,率的比较采用Rao-scott χ2检验。结果 在10 056名调查对象中,有4 609例参加了糖尿病社区管理,管理率为45.0%(95% CI:40.8%~49.2%)。女性的社区管理率(46.9%,95% CI:42.8%~51.0%)高于男性(43.0%,95% CI:38.1%~47.9%),农村地区人群管理率(50.4%,95% CI:46.3%~54.5%)高于城市地区(41.6%,95% CI:35.5%~47.6%)。管理率在不同年龄组间的差异有统计学意义(χ2=21.0,P<0.01),≥65岁组管理率最高,为49.2%(95% CI:43.6%~54.7%),35~44岁组最低,为35.2%(95% CI:27.9%~42.4%)。纳入糖尿病社区管理的患者的规范管理率为16.7%(95% CI:13.7%~19.7%),城市患者的规范管理率为19.7%(95% CI:15.3%~24.1%),高于农村(12.8%,95% CI:9.8%~15.8%)。参与社区糖尿病管理的患者治疗率为95.8%(95% CI:94.8%~96.9%)。女性患者的治疗率为97.0%(95% CI:96.0%~98.0%),高于男性(94.5%,95% CI:92.7%~96.4%)。纳入糖尿病管理患者的血糖控制率为34.6%(95% CI:31.5%~37.6%),≥65岁患者的血糖控制率最高,为38.2%(95% CI:33.4%~43.0%),45~54岁的患者血糖控制率最低,为34.4%(95% CI:26.7%~42.0%)。结论 中国≥35岁的糖尿病患者的社区规范管理率和血糖控制率较低,需要进一步提高社区配置和加强规范化管理。
英文摘要:
      Objective To investigate the community-based management of diabetes patients aged ≥35 years in China. Methods The subjects from 2013-2014 Chronic Non-communicable Disease and Risk Factor Surveillance in China were used in this study, those who were aged ≥35 years and diagnosed by doctors in hospitals at community level or above were selected through clustering sampling. Questionnaire was used to collect the data of subjects' general information, health status, the treatment and the control of blood glucose. Blood samples were taken from the subjects to detect the fasting blood glucose level and blood glucose level at 2 hours after oral administration of glucosum anhydricum. The subjects were weighted according to complex sampling scheme to calculated the different rates and 95%CI. The Rao-scott χ2 test was performed to test the differences in rates between the subgroups. Results The survey indicated that among the 10 056 diabetes patients aged ≥35 years and diagnosed with diabetes, 4 609 received management service in communities. After being weighted, the management rate of diabetes patients was 45.0%(95%CI:40.8%-49.2%). Females (46.9%, 95%CI:42.8%-51.0%) had higher management rate than males (43.0%, 95%CI:38.1%-47.9%). The management rate was higher in rural area (50.4%, 95%CI:46.3%-54.5%) than in urban area (41.6%, 95%CI:35.5%-47.6%). There was a significant age specific difference in the proportion of patients receiving management services (χ2=21.0, P<0.01), the rate of management was highest in the patients aged ≥65 years (49.2%, 95%CI:43.6%-54.7%), but lowest in the patients aged 35-44 years (35.2%, 95%CI:27.9%-42.4%). The overall standardized management rate of diabetes patients in communities was 16.7% (95%CI:13.7%-19.7%). The proportion of urban patients receiving standardized management service (19.7%, 95%CI:15.3%-24.1%) was higher than that of rural patients (12.8%, 95%CI:9.8%-15.8%). The overall treatment rate of diabetes patients in communities was 95.8% (95%CI:94.8%-96.9%). The treatment rate was higher in females (97.0%, 95%CI:96.0%-98.0%) than that in males (94.5%, 95%CI:92.7%-96.4%). The control rate of blood glucose in diabetes patients receiving management in communities was 34.6% (95%CI:31.5%-37.6%), and the highest blood glucose control rate was in the patients aged ≥65 years (38.2%, 95%CI:33.4%-43.0%), while the lowest blood glucose control rate was in the patients aged 45-54 years (34.4%, 95%CI:26.7%-42.0%). Conclusions Both the standardized management rate and blood glucose control rate were low in the diabetes patients aged ≥35 years in China. It is necessary to strengthen the allocation of medical resources in communities and standardized diabetes management.
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