中国全科医学 ›› 2023, Vol. 26 ›› Issue (02): 175-183.DOI: 10.12114/j.issn.1007-9572.2022.0623

所属专题: 内分泌代谢性疾病最新文章合集 神经系统疾病最新文章合集 脑健康最新研究合集

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缺血性脑卒中患者糖尿病患病现状及影响因素研究

刘凤东1, 张博强2, 阎涵2, 井丽2, 于晓晨2, 王丽2, 刘云飞2, 邢立莹2, 田园梦2,*()   

  1. 1110004 辽宁省沈阳市,东北大学医院护理部
    2110005 辽宁省沈阳市,辽宁省疾病预防控制中心慢病所
  • 收稿日期:2022-06-25 修回日期:2022-09-10 出版日期:2023-01-15 发布日期:2022-10-09
  • 通讯作者: 田园梦
  • 刘凤东,张博强,阎涵,等.缺血性脑卒中患者糖尿病患病现状及影响因素研究[J].中国全科医学,2023,26(2):175-183. [www.chinagp.net]
    作者贡献:刘凤东提出思路,负责论文的起草与撰写;张博强负责调查的实施、统计学分析;阎涵负责调查的实施、统计学分析;井丽负责调查的实施、统计学分析;于晓晨、王丽、刘云飞负责数据收集、采集、清洗;邢立莹提出研究思路,设计研究方案;田园梦负责最终版本修订,对论文负责。
  • 基金资助:
    2019年辽宁省重点研发计划项目(2019JH2/10300001)

Prevalence and Influenceing Factors of Diabetes in Ichemic Stroke Patients

LIU Fengdong1, ZHANG Boqiang2, YAN Han2, JING Li2, YU Xiaochen2, WANG Li2, LIU Yunfei2, XING Liying2, TIAN Yuanmeng2,*()   

  1. 1Department of Nursing, Northeastern University Hospital, Shenyang 110004, China
    2Liaoning Provincial Center for Disease Control and Prevention, Shenyang 110005, China
  • Received:2022-06-25 Revised:2022-09-10 Published:2023-01-15 Online:2022-10-09
  • Contact: TIAN Yuanmeng
  • About author:
    LIU F D, ZHANG B Q, YAN H, et al. Prevalence and influenceing factors of diabetes in ichemic stroke patients [J] . Chinese General Practice, 2023, 26 (2) : 175-183.

摘要: 背景 糖尿病是缺血性脑卒中发病、复发、致残、致死的重要危险因素,评估缺血性脑卒中患者的糖尿病患病现状,开展综合防控,可有效改善患者预后。目的 了解辽宁省缺血性脑卒中患者合并糖尿病现状,为有针对性的干预提供理论依据。方法 2017—2018年,通过分层抽样、整群抽样、随机抽样相结合的方法,对辽宁省6个县区28个行政村/社区≥40岁的980例缺血性脑卒中患者进行横断面调查。采用多因素Logistic回归分析缺血性脑卒中患者糖尿病患病、知晓、治疗和控制情况的影响因素。结果 辽宁省缺血性脑卒中患者糖尿病患病、知晓、治疗和控制率分别为29.5%(289/980)、63.3%(183/289)、56.4%(163/289)和47.2%(77/163)。多因素Logistic回归结果提示,居住地为城市〔OR=1.818,95%CI(1.317,2.508),P<0.001〕、有糖尿病家族史〔OR=2.790,95%CI(1.922,4.050),P<0.001〕、高血压〔OR=1.813,95%CI(1.160,2.834),P=0.009〕、高三酰甘油〔OR=2.312,95%CI(1.631,3.277),P<0.001〕、高低密度脂蛋白胆固醇〔OR=2.241,95%CI(1.300,3.865),P=0.004〕和超重或肥胖〔OR=1.562,95%CI(1.136,2.146),P=0.006〕是缺血性脑卒中患者罹患糖尿病的危险因素;居住地为城市〔OR=1.865,95%CI(1.086,3.203),P=0.024〕、有糖尿病家族史〔OR=2.402,95%CI(1.306,4.416),P=0.005〕利于糖尿病的知晓,高总胆固醇〔OR=0.389,95%CI(0.215,0.705),P=0.002〕不利于糖尿病的知晓;年龄60~69岁〔OR=3.052,95%CI(1.523,6.115),P=0.002〕、居住地为城市〔OR=1.866,95%CI(1.104,3.155),P=0.020〕、有糖尿病家族史〔OR=2.303,95%CI(1.275,4.161),P=0.006〕利于糖尿病的治疗,高总胆固醇〔OR=0.387,95%CI(0.210,0.713),P=0.002〕不利于糖尿病的治疗;居住地为城市〔OR=1.916,95%CI(1.021,3.595),P=0.043〕利于缺血性脑卒中合并糖尿病患者的血糖控制。结论 辽宁省缺血性脑卒中患者的糖尿病患病率较高,患病知晓、治疗和控制情况仍处于较低水平。居住地、有糖尿病家族史等因素与缺血性脑卒中患者糖尿病的知晓、治疗和控制情况有关,亟待开展相关综合防控。

关键词: 卒中, 缺血性卒中, 糖尿病, 患病率, 知晓率, 治疗率, 控制率, 影响因素分析, 辽宁

Abstract:

Background

Diabetes mellitus is an important risk factor for the onset, recurrence, disability and lethality of ischemic stroke. Assessing the prevalence of diabetes in patients with ischemic stroke, and carrying out targeted comprehensive prevention and control can effectively improve the prognosis of patients.

Objective

To understand the current situation of ischemic stroke patients complicated with diabetes in Liaoning Province, and to provide a theoretical basis for targeted intervention.

Methods

From 2017 to 2018, a cross-sectional survey of ischemic stroke patients (≥40 years old) in 28 villages/communities in 6 counties and districts in Liaoning Province was conducted by a combination of stratified sampling, cluster sampling, and random sampling. Multivariate logistic regression was used to analyze the influencing factors of diabetes prevalence, awareness, treatment and control of ischemic stroke patients.

Results

The prevalence, awareness, treatment, and control rates of diabetes among ischemic stroke patients in Liaoning Province were 29.5% (289/980) , 63.3% (183/289) , 56.4% (163/289) , and 47.2% (77/163) , respectively. Multivariate logistic regression suggested that urban residence〔OR=1.818, 95%CI (1.317, 2.508) , P<0.001〕, family history of diabetes〔OR=2.790, 95%CI (1.922, 4.050) , P<0.001〕, hypertension 〔OR=1.813, 95%CI (1.160, 2.834) , P=0.009〕, high triglycerides〔OR=2.312, 95%CI (1.631, 3.277) , P<0.001〕, high-low density lipoprotein cholesterol 〔OR=2.241, 95%CI (1.300, 3.865) , P=0.004〕, and being overweight or obese〔OR=1.562, 95%CI (1.136, 2.146) , P=0.006〕 were the risk factors to diabetes mellitus in ischemic stroke patients; Having an urban residence〔OR=1.865, 95%CI (1.086, 3.203) , P=0.024〕, and having a family history of diabetes〔OR=2.402, 95%CI (1.306, 4.416) , P=0.005〕 favored diabetes awareness, and high cholesterol〔OR=0.389, 95%CI (0.215, 0.705) , P=0.002〕 disfavored diabetes awareness; 60-69 years old〔OR=3.052, 95%CI (1.523, 6.115) , P=0.002〕, urban residence〔OR=1.866, 95%CI (1.104, 3.155) , P=0.020〕, family history of diabetes〔OR=2.303, 95%CI (1.275, 4.161) , P=0.006〕 favored the treatment of diabetes, and high cholesterol〔OR=0.387, 95%CI (0.210, 0.713) , P=0.002〕disfavored the treatment of diabetes; Urban residence〔OR=1.916, 95%CI (1.021, 3.595) , P=0.043〕 favored blood glucose control in patients with ischemic stroke and diabetes.

Conclusions

The prevalence of diabetes in patients with ischemic stroke in Liaoning Province is relatively high, while the awareness, treatment and control of the disease are still at a low level. Factors such as place of residence, having a family history of diabetes are beneficial for improving the knowledge, treatment, and control of diabetes in patients with ischemic stroke, and comprehensive prevention and control are urgently needed

Key words: Stroke, Ischemic stroke, Diabetes mellitus, Prevalence, Awareness, Treatment, Control, Root cause analysis, Liaoning