ADA 2013：20年来中国2型糖尿病住院患者的死亡原因分析

    2013年第73届美国糖尿病协会科学年会(ADA2013)于6月21日~25日在美国芝加哥隆重举办。在ADA2013年会上，解放军总医院杨国庆教授的一项研究“2型糖尿病住院患者死亡原因：中国一家三甲医院数据回顾性研究”发表在ADA2013会议摘要上，指出糖尿病患者的死亡原因和非糖尿病患者相似，但心血管疾病和脑血管疾病对糖尿病患者中的死亡威胁更大。
　　目标：这项回顾性研究比较了中国一家三甲医院过去20年(1993年1月1日-2012年12月31日)糖尿病和非糖尿病患者的死亡原因。
　　方法：通过筛选过去20年在我院住院治疗的所有死亡患者的病历，回顾分析糖尿病患者的死亡率趋势。
　　结果：根据住院病历记录，过去20年在我院住院治疗的589419例患者中，43634例患者患有糖尿病。9109例住院死亡患者中，糖尿病患者共有1926例(21.1%)，非糖尿病患者7183例(78.9%)，死亡率分别为44.1/1000和13.1/1000。糖尿病死亡患者中，男性的平均年龄是74.05(10.7)岁，女性是73.4(9.9)岁，而非糖尿病死亡患者中，男性平均年龄是67(14.5)岁，女性是64.8(15.9)岁。糖尿病患者的死亡原因包括：恶性肿瘤(32.02%)、心血管疾病(20.62%)、呼吸系统疾病(17.13%)、脑血管疾病(9.75%)和感染(14.3%)。而导致非糖尿病患者死亡的原因包括：恶性肿瘤(48.07%)，呼吸系统疾病(13.61%)，感染(10.63%)，心血管疾病(10.27%)和脑血管疾病(5.63%)。与非糖尿病患者相比，糖尿病患者在以下几方面死亡机率更高：恶性肿瘤(OR  2.84, 95% CI 2.65-3.05)，心血管疾病(OR 1.42 , 95% CI 1.33-1.52)，脑血管疾病(OR 1.46, 95% CI  1.34-1.59)，感染(OR 1.61, 95% CI 1.12-2.32)。
　　结论：糖尿病患者的死亡原因和非糖尿病患者相似，但糖尿病患者死亡原因中心血管疾病和脑血管疾病的OR值更高。

【研究摘要】
Causes of Mortality in Hospitalized Type 2 Diabetic Patients: Retrospective  Study of the Data from a Tertiary Hospital in China

Yang Guoqing MD Chinese PLA General Hospital

Objective: Our present retrospective study compared the causes of death in  diabetic and non-diabetic inpatients in a tertiary class hospital in the past 20  years(Jan 1 1993-Dec 31 2012).

Methods: In this retrospective study mortality  trends among people with diabetes admitted to our hospital were reviewed by  screening the in-patient’s records of all people who died over the last 20  years.

Results: Of 589 419 people admitted to our hospital during the past 20  years 43634 had diabetes mellitus according the in-patient medical records.  There were 9109 inpatient deaths registered 1926 (21.1%) in diabetic patients  and 7183 (78.9%) in non-diabetic patients and the mortality rate were 44.1/1000 and 13.1/1000 admissions for diabetic patients and non-diabetic patients  respectively. The mean (SD) age at death for people with diabetes was74.05  (10.7) years in men and 73.4 (9.9) years in women while the mean age at death  for non-diabetic patients was 67.0 (14.5) years in men and 64.8 (15.9) years in  women .Causes of death in diabetic patients were malignancy (32.02%)  cardiovascular disease (20.62%) respiratory system diseases(17.13%)  Cerebrovascular disease(9.75%) infection (14.3%) while the leading causes of  death in non-diabetic patients were malignancy (48.07%) respiratory system  diseases(13.61%) infection (10.63%) cardiovascular disease (10.27%)  Cerebrovascular disease(5.63%).Compared with non-diabetic patients diabetic  patients had significantly higher odds of death from malignancy(OR 2.84 95% CI  2.65-3.05) cardiovascular disease(OR 1.42 95% CI 1.33-1.52) Cerebrovascular  disease(OR 1.46 95% CI 1.34-1.59) infection(OR 1.61 95% CI  1.12-2.32).

Conclusions: The aetiological spectrum of mortality in people with  diabetes was similar with that in non-diabetic patients but the OR of coronary  artery disease and cerebrovascular disease were higher in people with  diabetes.