OSAHS合并2型糖尿病患者下肢血管病变的影响因素分析

发布时间：2018-07-14 20:49

【摘要】：目的探讨阻塞性睡眠呼吸暂停低通气综合征(Obstructive Sleep Apnea-Hypopnea Syndrome,OSAHS)合并2型糖尿病患者下肢血管病变的影响因素,寻找可控性危险因素,为早期采取护理干预措施提供依据。方法选择2014年12月至2016年12月在华北理工大学附属医院收治的OSAHS合并2型糖尿病患者中有下肢血管病变者224例作为观察组,选择同期收治的OSAHS合并2型糖尿病患者无下肢血管病变者224例作为对照组。两组患者均收集以下资料:1一般资料:性别、年龄、文化程度、吸烟、饮酒及医疗保险情况;2临床资料:血糖控制情况、糖尿病病程、OSAHS病情程度、OSAHS病程、体质指数、高血压史、血脂紊乱史;3家庭资料:家庭人均月收入、家庭关怀情况;4疾病管理资料:OSAHS自我管理水平(生活管理、治疗管理、知识技能管理、心理管理)、糖尿病治疗依从性(饮食依从性、运动依从性、药物治疗依从性、血糖监测依从性、自护行为依从性)。将收集的两组资料运用SPSS17.0统计软件进行对比分析,单因素分析采用卡方检验,多因素分析采用二元Logistic回归分析。结果1单因素分析显示,性别、吸烟、血糖控制水平、糖尿病病程、OSAHS病情程度、高血压、家庭关怀情况、OSAHS生活管理水平、OSAHS治疗管理水平、糖尿病治疗依从性、糖尿病饮食治疗依从性、糖尿病运动治疗依从性、糖尿病药物治疗依从性与OSAHS合并2型糖尿病患者下肢血管病变的发生有关,差异具有统计学意义(χ2值分别为8.145、4.390、25.456、13.642、14.425、3.938、7.855、8.423、7.555、6.300、4.057、6.204、4.600,均P0.05)。2多因素分析显示:吸烟、血糖控制水平、糖尿病病程、OSASH病情程度、高血压、家庭关怀情况、OSAHS生活管理水平、OSAHS治疗管理水平、糖尿病运动依从性、糖尿病药物治疗依从性为OSAHS合并2型糖尿病患者下肢血管病变的发生影响因素(OR值分别为1.658、2.800、1.753、1.899、1.647、2.110、2.131、2.063、1.664、1.598,均P0.05)。结论吸烟、血糖控制水平差、糖尿病病程在10年以上、中重度OSAHS、有高血压史、家庭关怀障碍、OSAHS生活管理水平和治疗管理水平差、糖尿病运动依从性和药物治疗依从性差是OSAHS合并2型糖尿病患者下肢血管病变发生的主要危险因素。
[Abstract]:Objective to investigate the influencing factors of lower extremity vascular lesions in patients with obstructive sleep apnea hypopnea syndrome (OSAHS) and type 2 diabetes mellitus, to find controllable risk factors and to provide evidence for early nursing intervention. Methods from December 2014 to December 2016, 224 OSAHS patients with type 2 diabetes mellitus who were admitted to the affiliated Hospital of North China University of Science and Technology were selected as the observation group. 224 cases of OSAHS with type 2 diabetes mellitus without lower extremity vascular disease were selected as control group. The two groups collected the following data: sex, age, education, smoking, alcohol consumption and medical insurance. 2 Clinical data: control of blood sugar, severity of OSAHS, history of OSAHS, body mass index, history of hypertension. History of dyslipidemia 3 Family data: monthly income per family, family care and disease management data: OSAHS self-management level (life management, treatment management, knowledge and skills management, psychological management), diabetes treatment compliance (diet compliance), Exercise compliance, drug therapy compliance, glucose monitoring compliance, self care behavior compliance). The two groups of data were compared and analyzed by SPSS 17.0 statistical software. The single factor analysis was chi-square test and the multivariate logistic regression analysis was used. Results 1 single factor analysis showed that sex, smoking, blood glucose control level, the degree of OSAHS, hypertension, family care, OSAHS treatment management level, diabetes treatment compliance, OSAHS life management level, diabetes treatment compliance; Diabetic diet compliance, diabetic exercise compliance and diabetic drug compliance were associated with the occurrence of lower extremity vascular lesions in patients with OSAHS and type 2 diabetes. The difference was statistically significant (蠂 ~ 2 = 8.145 卤4.390g 25.456N 13.642n 14.42553.938v 7.855v 8.4237.5556.3004.0576.2044.600, P0.05). The results of multivariate analysis showed that smoking, blood glucose control level, course of diabetes OSASH condition, hypertension, family care, living management level of OSAHS, OSAHS treatment and management level were higher than those of control group (P < 0.05). The risk factors of lower extremity vascular disease in patients with OSAHS combined with type 2 diabetes mellitus (OR = 1.6582.800) 1.899 / 1.6471.1102.131.131/ 2.063n / 1.664/ 1.598respectively (P0.05). Conclusion smoking, poor blood glucose control, the course of diabetes is more than 10 years, moderate and severe OSAHS, history of hypertension, family care disorder OSAHS living management level and treatment management level is poor. The main risk factors of lower extremity angiopathy in patients with OSAHS complicated with type 2 diabetes mellitus were poor compliance of exercise and drug therapy.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

【参考文献】