上海郊区2型糖尿病患者治疗过程中临床惰性现象的危险因素分析

桂婷婷; 陆晓怡; 厉倩; 陈佳; 肖元元; 翟大红

doi:10.7619/jcmp.20242643

上海郊区2型糖尿病患者治疗过程中临床惰性现象的危险因素分析

Analysis in risk factors of clinical inertia in treatment of patients with type 2 diabetes mellitus in suburbs of Shanghai

摘要

摘要:
目的探讨上海郊区2型糖尿病(T2DM)患者治疗过程中出现临床惰性的现状，并分析其危险因素。
方法选取2022年11月—2023年11月在上海市第六人民医院内分泌代谢科门诊就诊的1 804例T2DM患者为研究对象。依据患者治疗过程中是否发生临床惰性分为临床惰性组与非临床惰性组，并收集患者的人口学特征资料、临床资料。采用Logistic回归分析明确T2DM患者治疗过程中发生临床惰性的危险因素。
结果 T2DM患者临床惰性的发生率为52.00%(938/1 804)。多因素Logistic回归分析结果显示，糖尿病病程较长、高水平糖化血红蛋白(HbA1c)、高糖尿病问题量表(PAID)评分、口服药物≥2种、预期寿命短、合并视网膜病变为T2DM患者治疗过程中发生临床惰性的危险因素(P < 0.05)。
结论上海郊区T2DM患者治疗过程中临床惰性的发生率较高，血糖控制差、病程较长、高心理困扰水平、口服药物≥2种、预期寿命短、合并视网膜病变的T2DM患者更易发生临床惰性。

Abstract:
Objective To explore the current status of clinical inertia in the treatment of patients with type 2 diabetes mellitus (T2DM) in the suburbs of Shanghai and analyze its risk factors.
Methods A total of 1, 804 T2DM patients who visited the Endocrinology and Metabolism Clinic of Shanghai Sixth People's Hospital from November 2022 to November 2023 were selected as research objects. Patients were divided into clinical inertia group and non-clinical inertia group based on whether clinical inertia occurred during their treatment, and demographic and clinical data were collected. Logistic regression analysis was used to identify risk factors for clinical inertia in the treatment of T2DM patients.
Results The incidence of clinical inertia in T2DM patients was 52.00% (938/1, 804). The results of multivariate Logistic regression analysis showed that longer diabetes duration, high level of glycated hemoglobin (HbA1c), high score of the Problem Areas in Diabetes Scale(PAID) score, taking over two oral medications, shorter life expectancy, and coexisting retinopathy were risk factors for clinical inertia in the treatment of T2DM patients (P < 0.05).
Conclusion The incidence of clinical inertia is high in T2DM patients during treatment in the suburbs of Shanghai. T2DM patients with poor glycemic control, longer disease duration, high level of psychological distress, taking over two oral medications, shorter life expectancy, and coexisting retinopathy are more prone to occur clinical inertia.

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