中国城市三甲医院老年2型糖尿病患者生活质量及其影响因素

Quality of life and affecting factors in elderly patients with type 2 diabetes in Chinese tertiary hospitals

摘要:

目的 了解我国三甲医院中老年2型糖尿病患者的生活质量现状及其影响因素。方法 收集2015年3至11月16家三甲医院2型糖尿病费用调查研究中完成欧洲五维健康量表(EQ-5D)问卷、且年龄≥60岁的患者479例。采用线性回归模型分析患者的临床特征对生活质量的影响。采用SPSS 19.0统计软件进行数据分析。结果 191例(39.9%)患者报告至少一个维度存在问题。行动能力、自我照顾能力、日常活动能力、疼痛或不舒服、焦虑或抑郁方面报告存在问题的比例分别为15.0%、4.8%、9.0%、22.1%和24.2%。研究人群平均EQ-5D问卷总效值和直观式健康量表(EQ-VAS)分别为(0.77±0.13)和(76.9±11.9)。年龄(B=-0.003,P=0.021)、糖化血红蛋白(B=-0.010,P=0.037)和糖尿病周围神经病变(B=-0.039,P=0.01)是影响EQ-5D总效值的预测因素；糖化血红蛋白(B=-1.091,P=0.013)、糖尿病视网膜病变(B=-3.192,P=0.019)、心血管疾病(B=-3.470,P=0.019)和脑血管疾病(B=-4.649,P=0.003)是影响EQ-VAS评分的预测因素。 结论 2型糖尿病对老年患者的生活质量存在明显的影响,年龄、糖化血红蛋白、糖尿病慢性并发症以及心脑血管合并症是其重要的影响因素。

Abstract:

Objective To investigate the quality of life of the elderly patients with type 2 diabetes mellitus(T2DM) and identify the affecting factors. Methods Data were collected of 479 T2DM patients aged 60 years or above, who completed European quality of life-5 dimensions (EQ-5D) in the survey on the cost of T2DM in 16 tertiary hospitals from March to November 2015. Linear regression analyses were performed to identify the impact of clinical characteristics on the quality of life. SPSS statistics 19.0 was used for data analysis. Results Of 479 patients, 191 (39.9%) reported problems with at least one dimension. Patients reporting problems in mobility, self-care, usual activities, pain/discomfort and anxiety/depression accounted for 15.0%,4.8%,9.0%,22.1% and 24.2%, respectively. The average EQ-5D score and European quality of life-5 dimensions visual analogue scale (EQ-VAS) were(0.77±0.13) and(76.9±11.9). Age (B=-0.003, P=0.021), HbA1c (B=-0.010, P=0.037) and diabetic peripheral neuropathy (B=-0.039,P=0.01) were predictors of EQ-5D score. HbA1c (B=-1.091, P=0.013), diabetic retinopathy (B=-3.192, P=0.019), cardiovascular disease (B=-3.470, P=0.019) and cerebrovascular disease (B=-4.649, P=0.003) were predictive factors affecting EQ-VAS score. Conclusion T2DM has significant impact on the quality of life of the elderly patients. Age, HbA1c, chronic diabetic complications, cardiovascular and cerebrovascular comorbidities are affecting factors of the quality of life.