糖尿病规范化综合防治干预对石河子社区2型糖尿病患者代谢指标的影响研究

发布时间：2018-04-02 04:12

本文选题：社区　切入点：2型糖尿病　出处：《石河子大学》2015年硕士论文

【摘要】：目的:通过对糖尿病患者实施规范化综合防治干预,比较干预前后及不同频次的干预对血糖指标(FPG、2h PG、Hb Alc)、血脂指标(TC、TG、HDL-C、LDL-C)、体质指标(SBP、DBP、BMI)的影响,并分析干预效果,为今后石河子社区大面积推广开展社区糖尿病规范化综合防治干预提供依据。方法:采用整群随机抽样方法,在石河子所辖十二个社区内选取符合纳入标准的2型糖尿病患者,随机分为常规干预组和强化干预组。基线调查包括一般情况(年龄、性别、文化程度、职业、经济状况、联系方式)、既往史、糖尿病家族史、吸烟史、饮酒史、体格检查(身高、体重、腰围、臀围、SBP、DBP、BMI、WHR)、生活方式、膳食情况、临床症状、治疗方案、相关并发症等情况,并检测代谢指标,包括血糖指标(FPG、2h PG、Hb Alc)和血脂指标(TC、TG、HDL-C、LDL-C)。常规干预组于基线调查后1年内每六个月随访,强化干预组每三个月随访。随访干预内容主要为了解患者病情,评估治疗情况;有针对性地进行健康教育;询问患者饮食结构及运动量。每周监测血糖次数及结果,根据患者个人情况调整治疗方案,并抽血检测代谢指标(同基线)。应用Epidata3.02软件建立数据库文件并进行数据录入,用SPSS17.0查错,并进行数据分析。结果:1、基线纳入研究对象419例,随访一年后,结局随访312例,随访率为74.46%,其中,常规干预组172例,强化干预组140例。两组基线资料齐同(P0.05)。2、石河子市社区2型糖尿患者干预前血糖、血脂、血压达标情况:FPG、2hPG、HbA1c达标率分别为33.33%、25.32%,11.54%;HDL-C、LDL-C、TG达标率分别为87.50%、19.23%、24.68%;血压达标率为21.47%。3、常规干预前后血糖指标(FPG、2h PG、Hb Alc)、血脂指标(TC、TG、LDL-C)有显著差异(P0.05);强化干预前后血糖指标(FPG、2h PG、Hb Alc)、血脂指标(TC、TG、LDL-C)、体指指标(SBP、BMI)明显降低(P0.05);两组相比,2h PG、Hb Alc、TG、LDL-C、DBP差异有统计学意义(P0.05),随访四次效果明显优于两次。4、常规干预组干预前后2h PG、FPG、Hb Alc达标率较前略有升高,但差异无统计学意义(P0.05);强化干预组干预前后FPG、2h PG、Hb Alc达标率差异有显著性(P0.05),两组之间比较,Hb Alc达标率差异有显著性(P0.001)。5、常规干预前后TC、TG、LDL-C较前降低,差异有统计意义(P0.05);强化干预组干预前后TC、TG、LDL-C差异有统计学意义(P0.05);两组间比较,TG、LDL-C差异显著(P0.05)。6、常规干预前后,SBP、DBP、BMI差异无统计学意义(P0.05);强化干预前后,SBP、BMI较前降低,差异有统计学意义(P0.05);两组比较,SBP差异有统计学意义(P0.05)。结论:石河子市社区2型糖尿病患者血糖、血脂、体质指标控制情况较差。进行规范化综合防治干预后,患者的代谢指标较前改善,规范化综合防治干预是有效的。随访干预四次效果优于两次。
[Abstract]:Objective: to compare the effects of intervention before and after intervention and at different frequency on blood glucose index (FPG) 2 h PGHb Alcor, serum lipid index (TCX TGG) HDL-CnLDL-CU, physique index SBPnBPU BMI. objective: to compare the effects of intervention before and after intervention in diabetes mellitus patients by standardized comprehensive prevention and treatment, and to analyze the effects of intervention.It provides the basis for promoting and developing the comprehensive prevention and treatment of diabetes mellitus in Shihezi community in the future.Methods: a cluster random sampling method was used to select type 2 diabetes mellitus patients in 12 communities under Shihezi jurisdiction and were randomly divided into routine intervention group and intensive intervention group.The baseline survey included general conditions (age, sex, education, occupation, financial status, contact information, past history, family history of diabetes, smoking history, history of alcohol consumption, physical examination (height, weight, waist circumference, hip circumference, SBPDBP, BMIWHR, lifestyle).Dietary status, clinical symptoms, treatment plan, related complications, and so on. The metabolic indexes, including blood glucose index (FPG) 2 h PGN HbAlc) and blood lipid index (TCU TGN HDL-C), were detected.The routine intervention group was followed up every 6 months after the baseline survey, and the intensive intervention group was followed up every 3 months.The main contents of follow-up intervention were to understand the patient's condition, evaluate the treatment situation, carry out health education in a targeted way, and ask the patient about diet structure and the amount of exercise.The frequency and result of blood glucose were monitored weekly, the treatment plan was adjusted according to the individual condition of the patient, and the metabolic index was detected by blood sampling (same as baseline).Epidata3.02 software is used to build database files and input data, SPSS17.0 is used to check errors, and data analysis is carried out.Results one year after follow-up, 312 cases were followed up, the follow-up rate was 74.46%, 172 cases in routine intervention group and 140 cases in intensive intervention group.The baseline data of the two groups were the same as P0.05An. 2. The blood glucose and blood lipid of patients with type 2 glucose and urine before intervention in community of Shihezi city,The body finger index (SBPU BMI) was significantly lower than that of the control group (P 0.05), and the difference between the two groups was statistically significant (P 0.05), and the follow-up effect of four times was better than that of the two groups. The rate of reaching the standard of Alc in the routine intervention group before and after intervention was slightly higher than that before and after intervention, and the results showed that there was no significant difference between the two groups before and after the intervention, and there was no significant difference between the two groups before and after intervention.However, there was no significant difference between the two groups (P 0.05), and there was significant difference between the two groups before and after intervention (P 0.05), and there was a significant difference between the two groups in reaching the standard rate of HB Alc, and the TCG-LDL-C decreased before and after conventional intervention, and the difference was significant between the two groups before and after the intervention, and the difference was significant between the two groups before and after the intervention, and there was a significant difference between the two groups before and after the intervention, and the difference between the two groups was also significant.The difference was statistically significant (P 0.05), the LDL-C difference of TCU and TGG before and after intervention was statistically significant (P 0.05), the difference of LDL-C between the two groups was significant (P 0.05), and there was no significant difference in BMI between two groups before and after routine intervention (P 0.05), and the BMI of SBP before and after intensive intervention was lower than that before and after intensive intervention.The difference was statistically significant (P 0.05) and the difference of SBP between the two groups was statistically significant (P 0.05).Conclusion: the control of blood glucose, blood lipids and physique index of type 2 diabetes mellitus patients in Shihezi community is poor.After the intervention of standardized comprehensive prevention and treatment, the metabolic index of patients was improved, and standardized comprehensive prevention and treatment intervention was effective.The effect of four follow-up interventions was better than that of two.
【学位授予单位】：石河子大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R587.1

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