中国城市口服降糖药物治疗的2型糖尿病患者合并症与生活质量评价

摘要

目的 使用欧洲五维生活质量量表(EuroQol,EQ-5D)评价中国口服降糖药物治疗的2型糖尿病患者的生活质量,探讨不同合并症对患者生活质量的影响.方法 对全国9个城市75所城市医院的2型糖尿病患者进行问卷调查.使用logistic回归和多元线性回归调节社会经济学因素后探讨合并症对患者生活质量的影响.结果 共回收有效问卷7082份.患者平均年龄为59.6岁,48.28％为女性,患者EQ-5D和EQ-VAS得分分别为0.87和70.98.其中,81.45％的患者有合并症,合并症发生率最高的是高血压,有合并症患者在EQ-5D量表各维度以及综合得分方面显著差于没有合并症患者.Logistic回归结果显示,糖尿病足会显著增加患者行动和日常活动方面发生问题的风险,风险比(OR)分别是4.12和3.18.中风显著增加自我照顾方面发生问题的风险(OR=3.49),肾脏疾病显著增加焦虑方面发生问题的风险(OR=2.73).多元线性回归结果显示,糖尿病足对患者EQ-5D总得分的影响最大,其次是中风和肾脏类疾病.结论 口服药物治疗的2型糖尿病患者生活质量较差,合并症显著降低了患者的生活质量.%Objective To examine the quality of life in patients with type 2 diabetes treated with oral drugs and to evaluate the impact of complications on health utility of these patients in China.Methods A survey was conducted in type 2 diabetic patients from 75 hospitals situated in 9 cities.Patients' information was collected including demographic data,status of complications,and quality of life (EQ-5D).Logistic regression and multiple regression analyses were carried out to explore the impact of complications on health-related quality of life in these patients.Results Seven thousand and eighty-two patients completed the investigation.The mean HbA1C was 9.10％.81.45％ of participants experienced diabetic complications,the most frequent complication was hypertension (51.09％).In patients with complications,the EQ-5D scores and VAS scores were significantly lower than those without complications.Results of the Logistic regressions for the five dimensions of the EQ-5D showed that patients with diabetic foot were 4.12 times more likely to experience mobility problems than patients without complication,patients with stroke were 3.49 times more likely to experience self-care problem.Multiple linear regression results showed that diabetic foot had the worst effect on the overall EQ-5D score,followed by stroke and nephropathy.Conclusions Type 2 diabetic patients with oral drug treatment experienced poor quality of life.Complications were associated with decreased quality of life among diabetic patients.