社區(qū)糖耐量異常人群篩查模型的建立與評(píng)價(jià)

黃建生+曾志強(qiáng)+張艷荷

[摘要] 目的 探討社區(qū)糖耐量異常人群篩查模型的建立及其評(píng)價(jià)。方法 對(duì)2016年4月～2017年6月社區(qū)糖尿病流行病學(xué)調(diào)查結(jié)果進(jìn)行回顧性分析，在該階段通過對(duì)危險(xiǎn)因素進(jìn)行分析后采取危險(xiǎn)因素計(jì)分法建立社區(qū)糖耐量異常人群篩查模型，以該模型篩查社區(qū)1560名一般人群糖耐量異常情況，并分析篩查結(jié)果。結(jié)果 采取危險(xiǎn)因素計(jì)分法累積積分≥5分建立的社區(qū)糖耐量異常人群篩查模型篩查1560名社區(qū)一般人群，其中770例采取口服葡萄糖耐量試驗(yàn)（OGTT）診斷，篩查出目標(biāo)人群中有80例糖耐量異常者。結(jié)論 通過危險(xiǎn)因素計(jì)分法建立的社區(qū)糖耐量異常人群篩查模型篩查社區(qū)糖耐量異常人群操作簡(jiǎn)單方便，經(jīng)濟(jì)有效，可在社區(qū)進(jìn)行糖尿病前期人群篩查，從而為盡早做好預(yù)防干預(yù)提供可靠的依據(jù)。

[關(guān)鍵詞]社區(qū)；糖耐量異常；人群篩查；模型

[中圖分類號(hào)] R195；R587.1 [文獻(xiàn)標(biāo)識(shí)碼] A [文章編號(hào)] 2095-0616（2017）20-251-03

Establishment and evaluation of screening model for community population with impaired glucose tolerance

HUANG Jiansheng ZENG Zhiqiang ZHANG Yanhe

Humen Town Community Health Centre of Dongguan City， Dongguan 523907， China

[Abstract] Objective To investigate the establishment and evaluation of screening model for community population with impaired glucose tolerance. Methods The epidemiological survey of diabetes mellitus in community from April 2016 to June 2017 was conducted retrospectively. At the same stage， the risk factors were analyzed and used to establish screening model of community with abnormal glucose tolerance by risk factor scoring method. The model was used to screen abnormal glucose tolerance in 1560 general population communities， and the screening results were analyzed. Results A total of 1560 community general population were screened by screening model of community with abnormal glucose tolerance established by risk factor score of accumulated points more than 5 points. 770 cases were diagnosed by oral glucose tolerance test （OGTT）， and there were 80 patients with impaired glucose tolerance who were screened for the target population. Conclusion Screening model of abnormal glucose tolerance in community established by risk factor scoring method for screening community populations with impaired glucose tolerance is simple to operate and economical and effective. It can be used for screening pre diabetes population in the community， so as to provide reliable evidence for early intervention.

[Key words] Community； Impaired glucose tolerance； Mass screening； Model

糖耐量減低（IGT）是主要的糖調(diào)節(jié)異常情況，過去曾叫做無癥狀糖尿病或化學(xué)性糖尿病、糖尿病前期等，IGT是糖代謝正常和糖尿病的中間狀態(tài)，研究指出所有2型糖尿病患者均要經(jīng)過IGT環(huán)節(jié)[1-3]?；诖?，盡早發(fā)現(xiàn)IGT，并采取有效的措施干預(yù)，對(duì)于預(yù)防其進(jìn)展為糖尿病，以及改善這類人群的生活質(zhì)量有著積極的意義[4]。傳統(tǒng)口服葡萄糖耐量試驗(yàn)（OGTT）篩查IGT人群有一定的診斷價(jià)值，但費(fèi)用較高，效能較差[5]。隨著研究增多，目前一些學(xué)者指出可建立糖耐量異常篩查模型，提高篩查效率[6]，本次就流行病學(xué)調(diào)查基礎(chǔ)上采取危險(xiǎn)因素記分法建立社區(qū)糖耐量異常人群篩查模型，并對(duì)社區(qū)人群進(jìn)行實(shí)際應(yīng)用以便驗(yàn)證該模型的實(shí)用性，現(xiàn)將結(jié)果報(bào)道如下。

1 資料與方法

1.1 一般資料

對(duì)2016年4月～2017年6月社區(qū)糖尿病流行病學(xué)調(diào)查結(jié)果進(jìn)行回顧性分析，該階段流行病學(xué)調(diào)查共計(jì)有建模人群1390人，其中男740例、女650例；年齡20～85歲，平均（58.9±10.4）歲；其中糖耐量異常有125例，其余為非糖耐量異常者（包括糖尿病患者）。此外，在該階段通過對(duì)危險(xiǎn)因素進(jìn)行分析后采取危險(xiǎn)因素計(jì)分法建立社區(qū)糖耐量異常人群篩查模型，以該模型篩查社區(qū)1560名一般人群糖耐量異常情況，其中男831例、女729例；年齡18～80歲，平均（57.7±10.9）歲。本次研究對(duì)象均為東莞市虎門鎮(zhèn)社區(qū)人群。endprint