青岛市社区三高控制现状及影响因素

The Current Situation and Influencing Factors of “Three Highs” Control in Communities of Qingdao

摘要: 目的：通过对比青岛市城乡老年人健康查体资料分析城乡三高防治差异为诊疗提供资料。方法：整群抽样2023年青岛市城市社区497例老年人查体资料，采用倾向性匹配乡村社区497例老年人查体资料进行统计学对比分析。结果：共994人，年龄65~97 (80.12 ± 5.05)岁，男性448人，约45%，女性546人，约55%，糖尿病患病率27.2%，糖尿病药物治疗率88.4%，空腹血糖控制达标率49.62%，二甲双胍药物治疗率70.0%，SGLT-2抑制剂治疗率10.5%，GLP-1RAS治疗率0%；城市社区糖尿病患者血糖控制达标率29.78%，药物治疗率81.6%，药物治疗后达标率52.6%，在患者人群中，双胍类治疗的使用率64.7%、SGLT-2抑制剂的使用率12.0%、GLP-1RAS的使用率0%；乡村社区糖尿病患者血糖控制达标率24.55%，药物治疗率99%，药物治疗后达标率37.5%，在患者人群中，双胍类的使用率76.9%、SGLT-2抑制剂的使用率8.7%、GLP-1RAS的使用率0%；城市肥胖率21.5%，乡村肥胖率21.3%。结论：1. 乡村糖尿病药物治疗率高于城市社区，青岛市社区老年人群心血管疾病危险因素管理存在城乡异质性，社区慢病管理在心血管疾病危险因素管理中发挥重要作用。2. 糖尿病管理可降低对人民健康和社会经济发展带来的不良影响。

Abstract: Objective: To provide information for different diagnosis and treatment by comparing the health checkup data of the elderly in urban and rural areas of Qingdao. Methods: A total of 497 elderly people’s health checkup data from urban communities in Qingdao in 2023 were selected by cluster sampling, and the data were statistically compared with those of 497 elderly people from rural communities after propensity score matching. Results: A total of 994 people were included, aged 65 to 97 (80.12 ± 5.05) years, with 448 males (about 45%) and 546 females (about 55%). The prevalence of diabetes was 27.2%, the rate of drug treatment for diabetes was 88.4%, the rate of achieving the target fasting blood glucose was 49.62%, the rate of metformin treatment was 70.0%, the rate of SGLT-2 inhibitor treatment was 10.5%, and the rate of GLP-1RAS treatment was 0%. The rate of achieving the target blood glucose in urban community diabetic patients was 29.78%, the rate of drug treatment was 81.6%, and the rate of achieving the target after drug treatment was 52.6%. Among the patients, the usage rate of biguanides was 64.7%, the usage rate of SGLT-2 inhibitors was 12.0%, and the usage rate of GLP-1RAS was 0%. The rate of achieving the target blood glucose in rural community diabetic patients was 24.55%, the rate of drug treatment was 99%, and the rate of achieving the target after drug treatment was 37.5%. Among the patients, the usage rate of biguanides was 76.9%, the usage rate of SGLT-2 inhibitors was 8.7%, and the usage rate of GLP-1RAS was 0%. The obesity rate in urban areas was 21.5%, and that in rural areas was 21.3%. Conclusion: 1. The rate of drug treatment for diabetes in rural areas is higher than that in urban communities. There are urban-rural differences in the management of cardiovascular disease risk factors among the elderly in Qingdao communities, and primary care plays an important role in the management of cardiovascular disease risk factors. 2. The management of diabetes can reduce the adverse impact on people’s health and social and economic development.