·糖尿病临床研究·

　　【摘要】 目的 观察新诊断T2DM患者综合管理6年后代谢指标的达标情况并分析其影响因素。方法 157例新诊断T2DM患者专人管理并定期随访，给予综合干预。 结果 (1)随诊6年后 SBP、DBP、FPG、2 hPG、HbA1c、TG、TC、LDL-C水平较干预前降低， HDL-C升高(P<0.05)。随诊6年后与新诊断时达标率为： SBP：75.2% vs 52.9%，DBP：66.9% vs 40.8%，BP：61.8% vs 33.1%，FPG：59.2% vs 19.7%，2hPG：74.5% vs 22.9%，HbA1C：52.9% vs 29.9%，TC：59.2% vs 37.6%，TG：58.6% vs 36.3%，HDL-C：69.4% vs 43.3%，LDL-C：52.9% vs 29.3%，BMI：42.7% vs 38.9%。(2)糖尿病知识得分、运动和血糖监测次数与血糖不达标呈独立负相关。(3)不达标组颈动脉内膜-中层厚度(IMT)增厚发生率高于达标组;不达标组DR发生率、糖尿病慢性肾脏疾病(CKD)发生率高于达标组。 结论 长期综合管理可提高T2DM患者血糖达标率。血糖、血压、血脂和BMI不达标可增加糖尿病血管并发症的发生。

　　【关键词】糖尿病, 2型;达标率;影响因素;糖尿病并发症

The Factor analysis of patients reaching the recommended targets of metabolic index in patients with type 2 diabetes after 6-year follow-up of intensive multifactorial intervention ZHAO Chun-yan，YANG Jian-mei，WANG Hong，et al. Department of Endocrinology，Miyunxian Hospital，Beijing 101500，China

　　【Abstract】 Objective To investigate the proportion of patients who reached the recommended treatment targets of metabolic indexes T2DM during 6-year follow-up of after intensive multifactorial intervention,and to analyze the relative influencing factors. Methods 157 patients with newly onset T2DM received intensive multifactorial intervention and were followed up periodically. Results (1) After 6-year follow-up of intensive multifactorial intervention， the levels of systolic blood pressure (SBP), diastolic blood pressure(DBP), FPG, 2 hPG, HbA1c, TG, TC and LDL-C were significantly decreased while the HDL-C level was significantly increased and there was no significant difference in the BMI level . The rate of achievement targets at follow-up 6-year versus initial diagnosis were 75.2% vs 52.9% for SBP, 66.9% vs 40.8% for DBP, 61.8 vs 33.1% for BP, 59.2% vs 19.7% for FPG,74.5% vs 22.9% for 2 hPG, 52.9% vs 29.9% for HbA1c, 59.2% vs 37.6% for TC, 58.6% vs 36.3% for TG, 69.4% vs 43.3% for HDL-C,52.9% vs 29.3% for LDL-C , 42.7% vs 38.9% for body mass index (BMI) respectively. (2) Multiple logistic regression analysis showed that high scores of knowledge about diabetes, exercise and self-monitoring of blood glucose (SMBG) were correlated with achievement targets of blood glucose. (3) The prevalence of carotid artery intima-media thickening, chronic kidney disease(CKD)in dibetes and DR in treatment non-targeting group was significantly higher than in treatment targeting group (P<0.05). Conclusion Long-term intensive multifactorial intervention is an effective therapy in improving glucose,BP, Lipids targeting rate. High scores of knowledge about diabetes, exercise and SMBG can facilitate the achievement targets of blood glucose. The risk of diabetic angiopathy maybe increased in patients whose blood glucose, blood pressure, blood lipid and BMI do not reach the recommended targets.

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　　【Key words】 Diabetes mellitus，type 2; Success rate; Influencing factor; Complication of diabetes