2型糖尿病患者平衡功能的影响因素分析

发布时间：2018-11-04 10:25

【摘要】：目的:评估2型糖尿病患者的平衡功能,找出2型糖尿病患者平衡功能的主要影响因素。为医护人员提供准确的跌倒风险评估,及时发现潜在的跌倒者,并结合患者的临床特征,对患者采取有效的干预方法,提高2型糖尿病患者的平衡功能,降低跌倒发生率提供理论依据。方法:选取2016年2月~7月在河北省保定市第一中心医院内分泌科住院的2型糖尿病患者294例,收集患者的年龄、性别、身高、体重、运动情况资料;治疗用药情况、有无高血压、冠心病、骨质疏松症,糖尿病并发症;实验室检查结果包括空腹血糖、糖化血红蛋白、总胆固醇、甘油三酯、空腹血清胰岛素、血清25(OH)D3等。查阅病历获得相关疾病检查及诊断资料,应用多普勒血流探测仪测量并计算出踝肱比;使用Tetrax平衡测量仪测量患者八个姿势下的平衡参数,并生成跌倒指数。以跌倒指数作为因变量,以独立样本t检验和单因素方差分析有统计学意义的变量作为自变量进行多元回归分析,分析这些自变量对跌倒指数的影响作用。结果:1.294例患者的跌倒指数从1~100,平均47.86±8.18,其中128例患者的跌倒指数从1~36,平均22.82±9.42,处于低度跌倒风险,166例患者的跌倒指数从37~100,平均67.48±21.57,处于中高度跌倒风险。2.独立样本t检验和单因素方差分析有统计学意义的变量是年龄(t=16.61,P0.001)、文化程度(F=3.169,P=0.025)、运动情况(t=-4.804,P0.001)、用药治疗情况(F=5.662,P=0.001)、高血压(t=-2.686,P=0.008)、冠心病(t=-1.742,P=0.012)、病程(F=10.325,P0.001)、糖化血红蛋白(t=-2.339,P=0.020)、糖尿病神经病变(t=-2.216,P=0.027)、糖尿病视网膜病变(t=-3.446,P=0.001)、糖尿病肾病(t=-3.556,P0.001)、糖尿病下肢血管病变(t=-3.281,P=0.001)。3.以跌倒指数作为因变量,用药治疗情况、运动情况、高血压、文化程度、糖尿病视网膜病变、糖尿病肾病、糖尿病神经病变、糖尿病下肢血管病变、年龄、病程、冠心病、糖化血红蛋白进入多元逐步回归分析,结果运动情况(β=-0.320,P0.001)、年龄(β=0.220,P0.001)、糖尿病视网膜病变(β=0.160,P=0.005)、糖尿病肾病(β=0.156,P=0.007)、糖化血红蛋白(β=0.143,P=0.012)、用药治疗情况(β=0.135,P=0.017)最终进入方程。R2显示6个变量共同解释了跌倒指数总变异的27.6%。变量对2型糖尿病患者跌倒指数的贡献大小从高到低依次为运动情况、年龄、糖尿病视网膜病变、糖尿病肾病、糖化血红蛋白、用药治疗情况。结论:运动情况、年龄、糖尿病视网膜病变、糖尿病肾病、糖化血红蛋白、用药治疗情况是2型糖尿病患者平衡功能的主要影响因素。平衡功能障碍是内部因素和外部因素协同作用的结果。因此,患者可根据自身状况选择适宜的运动形式来提高平衡功能,积极控制血糖,在用药过程中应该注意用药安全,积极治疗延缓并发症出现,注意潜在的危险防止跌倒。
[Abstract]:Objective: to evaluate the balance function of type 2 diabetes mellitus and to find out the main influencing factors. In order to improve the balance function of patients with type 2 diabetes mellitus, we can provide an accurate assessment of fall risk for medical staff, find out potential falls in time, and take effective intervention to patients with type 2 diabetes combined with the clinical characteristics of the patients, so as to improve the balance function of patients with type 2 diabetes mellitus. To reduce the incidence of falls provides a theoretical basis. Methods: 294 patients with type 2 diabetes mellitus were selected from the Endocrinology Department of the first Central Hospital of Baoding City, Hebei Province from February to July 2016. The data of age, sex, height, weight and exercise were collected. Treatment, medication, hypertension, coronary heart disease, osteoporosis, diabetes complications; Laboratory results included fasting blood glucose, glycosylated hemoglobin, total cholesterol, triglyceride, fasting serum insulin, serum 25 (OH) D 3 and so on. The ankle-brachial ratio was measured by Doppler blood flow detector, and the balance parameters of eight postures were measured by Tetrax balance meter, and the fall index was generated. The fall index was used as dependent variable, and the independent sample t test and single factor variance analysis were used as independent variables to carry out multivariate regression analysis to analyze the effect of these independent variables on fall index. Results: the fall index of 1.294 patients ranged from 1 to 100 (mean 47.86 卤8.18). The fall index of 128 patients ranged from 1 to 36, with an average of 22.82 卤9.42, which was at a low risk of falling. The fall index of 166 patients ranged from 37 to 100, with an average of 67.48 卤21.57. At moderate height fall risk. 2. The independent sample t-test and univariate ANOVA were age (t 16.61), education level (F = 3.169), exercise (t = -4.804) and exercise status (t = 4.804 / P0.001). The course of treatment (FN 10.325 P0.001), glycosylated hemoglobin (TG-2.339U, P0.020), coronary heart disease (TV-1.742U, P0. 012), hypertension (tn-2. 686U, P0. 008), course of disease (FN 10. 325 P0. 001), hemoglobin glycosylated hemoglobin (tn)-2. 339U P0. 020), Diabetic neuropathy, diabetic retinopathy, diabetic nephropathy, diabetic lower extremity vasculopathy, diabetic neuropathy, diabetic retinopathy, diabetic nephropathy, and diabetic lower extremity vascular disease, respectively. P0. 001). With fall index as dependent variable, medication treatment, exercise, hypertension, education, diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, diabetic lower extremity vascular disease, age, course of disease, coronary heart disease, diabetic retinopathy, diabetic nephropathy, diabetic neuropathy, diabetic lower extremity vascular disease, age, course of disease, coronary heart disease, The results of multiple stepwise regression analysis of glycosylated hemoglobin were as follows: exercise (尾 = -0.320), age (尾 = 0.220), diabetic retinopathy (尾 = 0.160), diabetic nephropathy (尾 = 0.156), diabetic retinopathy (尾 = 0.160), diabetic nephropathy (尾 = 0.156). P0. 007), glycosylated hemoglobin (尾 = 0. 143, P0. 012), drug treatment (尾 = 0. 135, P0. 017) finally entered the equation. R2 showed that 6 variables explained the total variation of fall index. The contribution of variables to the fall index of type 2 diabetes mellitus patients from high to low in order of movement, age, diabetic retinopathy, diabetic nephropathy, glycosylated hemoglobin, drug treatment. Conclusion: exercise, age, diabetic retinopathy, diabetic nephropathy, glycosylated hemoglobin and medication are the main factors influencing the balance function of type 2 diabetic patients. Balance dysfunction is the result of synergy between internal and external factors. Therefore, patients can choose appropriate exercise form according to their own conditions to improve the balance function, actively control blood sugar, should pay attention to drug safety, active treatment to delay the occurrence of complications, pay attention to potential dangers to prevent falls.
【学位授予单位】：河北大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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