【摘要】 目的探讨2型糖尿病(T2DM)患者并发症的发生时间及影响从糖尿病发病到开始出现并发症时间长短的因素,为2型糖尿病慢性并发症的防治提供依据。方法采用生存分析方法,收集194名至少合并一种慢性并发症的2型糖尿病患者的社会人口学特征、疾病史、家族史、饮食习惯、生活方式资料,糖尿病诊断日期和诊断第一种慢性并发症时的日期,定义两个日期的时间间隔为生存时间,定义糖尿病某种慢性并发症的发生为观察终点。应用寿命表法计算生存时间及生存率(n年后患者未发生慢性并发症者占总观察人数的比例),用Log-rank检验比较每个研究因素各水平间生存率差异,用Cox风险比例模型分析2型糖尿病患者慢性并发症发生时间的影响因素。结果 194名T2DM患者1年后未发生并发症者占总观察人数的82.7%,5年占60.8%,10年占31.1%。中位发病时间为7.42年。Log-rank检验结果表明糖尿病诊断年龄、是否有血脂异常、是否经常有精神压力3个因素各水平之间2型糖尿病患者未发生慢性并发症的百分比差异有统计学意义。多因素Cox回归分析显示影响从糖尿病发病到开始出现并发症时间长短的因素及其OR值为:精神压力(OR=1.394,95%CI=1.086～1.790)和诊断年龄(OR=2.967,95%CI=1.296～6.797)。结论 194名患者患并发症的中位生存时间为7.42年,糖尿病诊断年龄、精神压力与2型糖尿病并发症发生的早晚有关。更多还原

【Abstract】 Objective To investigate the influential factors of the time from the diagnosis date of type 2 diabetes mellitus ( T2DM ) to the diagnosis date of T2DM chronic complications in order to provide evidence for T2DM chronic complications prevention and control. Methods A survival analysis was carried to explore the factors associated with the time from the diagnosis date of DM to the diagnosis date of DM complications.We recruit DM diagnosis date of DM , diagnosis date of first DM complication , demographic characteristics , disease history , disease family history , diet , living and behavioral pattern , social psychological characteristics and clinical data of 194 T2DM patients with a kind of DM chronic complication at least.Survival time was defined as time between DM diagnosis date and the first DM complication diagnosis date.The end-point was defined as the occurrence of certain kind of T2DM complications.Life-table method was used to calculate survival time and surviva rate.The Log-rank analysis were used to compare the survival rate between various levels of factors.Cox regression were used to analyze the factors associated with the survival time. Results The study showed that over-all DM complications-free rates were 82.7% at 1 year , 60.8% at 5 years , 31.1% at 10 years.The median survival time is 7.42 years.The positive results found with Log-rank analysis are age at diagnosis , dyslipi-demia , mental stress.The Cox regression result shows that mental stress ( OR=1.394 , 95% CI=1.086～1.790 ), age at diagnosis ( OR=2.967 , 95% CI=1.296～6.797 ) are factors associated with the time from the diagnosis date of DM to the diagnosis date of DM complications. Conclusion The median survival time is 7.42 years.Age at diagnosis and mental stress are independently factors associated with survival time of chronic complications.更多还原