摘要
目的探讨中国合并糖尿病的缺血型脑卒中患者的分布特征及对降血糖药物的依从性。方法选取中国脑卒中筛查项目2013—2015筛查年度的23044例缺血型脑卒中患者为研究对象,采用统一研制的调查问卷采集基本人口学信息、脑卒中病史及筛查当年之前的相关危险因素暴露情况,并了解脑卒中类型、诊断时间、发病次数、相关慢性病病史及治疗情况。采用多因素非条件logistic回归模型分析缺血型脑卒中患者合并糖尿病的影响因素,并估算各因素的人群归因危险度百分比(PARP),同时分析对降血糖药物的依从性。结果23044例缺血型脑卒中患者年龄为(64.99±9.42)岁,男性占50.91%(11731名),合并糖尿病者占21.52%(4960名)。多因素logistic回归模型分析结果显示,伴有高血压、血脂异常、心房颤动和脑卒中家族史的缺血型脑卒中患者中,合并糖尿病的风险更高,其OR(95%CI)值分别为2.18(1.87~2.55),1.99(1.78~2.23),1.64(1.39~1.92)和1.19(1.06~1.33);考虑各因素在缺血型脑卒中患者中的暴露率后,心房颤动的PARP(95%CI)值为62.65%(61.27%~63.76%)。合并糖尿病的缺血型脑卒中患者中,降血糖药物的服药率为70.73%(3463/4896)。结论中国合并糖尿病的缺血型脑卒中患者占比仍然较高,其对降血糖药物的依从率较低。
Objective To investigate the epidemiological characteristics and adherence to hypoglycemic agents of the ischemic stroke patients combined with diabetes.Methods The study recruited 23044 ischemic stroke cases from 2013-2015 screening period of China National Stroke Screening Survey.Standardized questionnaires were used to obtain information on demographic data,stroke history,the presence of influence factors,as well as the type of stroke,diagnosis date,frequency,chronic diseases history and hypoglycemic therapy.We used logistics model to investigate the possible risk factors of ischemic stroke combined with diabetes,and calculated the population attributable risk proportion(PARP).We also investigate the adherence to hypoglycemic agents.Results The mean age of 23044 ischemic stroke patients was(64.99±9.42)years old,50.91%were males(11731).In ischemic stroke patients,21.52%had diabetes.According to the results of logistics model,ischemic stroke patients with hypertension,dyslipidemia,atrial fibrillation or family history of stroke had higher risk to combine with diabetes,their Odds Ratios(OR)were 2.18(1.87-2.55),1.99(1.78-2.23),1.64(1.39-1.92)and 1.19(1.06-1.33).Considering the prevalence of each influence factor in ischemic stroke patients,atrial fibrillation had the highest PARP(95%CI)of 62.65%(61.27%-63.76%).In ischemic stroke patients combined with diabetes,70.73%(3463/4896)had taken hypoglycemic agents.Conclusion There still were a large number of ischemic stroke patients combined with diabetes and a low rate of adherence to hypoglycemic agents.
作者
郭健
关天嘉
王陇德
巢宝华
刘远立
Guo Jian;Guan Tianjia;Wang Longde;Chao Baohua;Liu Yuanli(Department of Cardiology and Medical Research Center,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100730 China;School of Public Health,Peking Union Medical College,Beijing 100005,China;School of Public Health,Peking University Health Science Center,Beijing 100083,China;China Stroke Data Center,Beijing 100101,China)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2021年第8期952-957,共6页
Chinese Journal of Preventive Medicine
基金
国家自然科学基金 (71532014)。
关键词
卒中
糖尿病
横断面研究
二级预防
Stroke
Diabetes mellitus
Cross-sectional studies
Secondary prevention
