| 秦莉,牛静雅,周金意,张庆军,周芳,张宁,周正元,盛红艳,任世成,苏健,朱慈华,吕红艳,王文绢.社区糖尿病患者周围神经病变的患病率及其影响因素研究[J].中华流行病学杂志,2019,40(12):1578-1584 |
| 社区糖尿病患者周围神经病变的患病率及其影响因素研究 |
| Prevalence and risk factors of diabetic peripheral neuropathy in Chinese communities |
| 收稿日期:2019-04-23 出版日期:2019-12-20 |
| DOI：10.3760/cma.j.issn.0254-6450.2019.12.014 |
| 中文关键词: 周围神经病变 糖尿病 患病率 影响因素 横断面调查 |
| 英文关键词: Peripheral neuropathy Diabetes Prevalence Risk factors Cross-sectional study |
| 基金项目:世界糖尿病基金会项目（WDF13-805） |
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| 中文摘要: |
| 目的 了解社区管理2型糖尿病患者的周围神经病变流行现况及其影响因素。方法 本研究基于"中国糖尿病足病预防模式项目"基线调查，采用二阶段整群随机抽样的方法抽取武汉市江岸区和江苏省常熟市社区管理的2型糖尿病患者2 528名，进行问卷调查、体格检查及血糖检测。采用非条件多因素logistic模型进行影响因素分析。结果 本次调查有效问卷共2 453份，有效调查率为97.0%，糖尿病患者的周围神经病变患病率为71.2%。多因素分析结果显示，年龄≥ 60岁（OR=2.39，95% CI：1.95~2.94）、糖尿病病程≥ 10年（OR=1.25，95% CI：1.02~1.54）和餐后2 h血糖控制不达标（OR=1.65，95% CI：1.33~2.04）是糖尿病周围神经病变的危险因素；文化程度较高是保护性因素，与小学及以下组相比，初中、高中/中专/技校、大专及以上组的糖尿病患者周围神经病变的OR值分别为0.52（95% CI：0.41~0.66）、0.59（95% CI：0.44~0.79）、0.64（95% CI：0.44~0.94）。结论 社区管理2型糖尿病患者的周围神经病变患病率高，年龄、糖尿病病程、餐后血糖控制不达标是糖尿病患者周围神经病变的危险因素，较高的文化程度是保护因素，在基层卫生服务机构开展糖尿病患者周围神经病变的筛查很有必要。同时，应加强对糖尿病患者的规范化管理和针对性的健康教育，以有效控制血糖和预防控制周围神经病变，早期预防糖尿病足病的发生。 |
| 英文摘要: |
| Objective To investigate the prevalence and risk factors of diabetic peripheral neuropathy in type 2 diabetic patients under community management programs. Methods A cross-sectional study was conducted on T2DM patients in eight communities in Wuhan and Changshu cities. Data would included questionnaire, body measurement, blood testing and clinical examination. The criterion of diabetic peripheral neuropathy was under the combination of symptoms with five physical examinations. Binary logistic regression model was used to analyze the influential factors. Results The overall prevalence of peripheral neuropathy was 71.2% among the diabetic patients who were managed in primary care health services in the two cities. The binary logistic regression method identified older age (≥ 60 years, OR=2.39, 95% CI:1.95-2.94), longer diabetic duration (≥ 10 years, OR=1.25, 95% CI:1.02-1.54), and worse postprandial glucose control (2 h postprandial plasma glucose >10.0 mmol/L:OR=1.65, 95% CI:1.33-2.04) (all P<0.05) as risk factors for the presence of diabetic peripheral neuropathy, while higher education level was protective factor (compared to patients with education levels of primary school or below, OR=0.52, 95% CI:0.41-0.66; OR=0.59, 95% CI:0.44-0.79; OR=0.64, 95% CI:0.44-0.94 for those with education levels of junior high school, senior high school, and college, respectively). Conclusions High rates of diabetic peripheral neuropathy among T2DM patients suggested the urgent need for early screening and standardized management at the community levels. It is necessary to promote appropriate screening techniques and methods to identify the peripheral neuropathy, in the primary health service institutions. |
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