摘要目的 分析住院患者中2型糖尿病(T2DM)的患病率、病死率以及死亡原因.方法 汇总分析1993年1月1日至2012年12月31日解放军总医院所有科室住院患者的病例资料.分别计算每年住院患者T2DM的患病率、病死率及所有死亡患者中T2DM患者的构成比等；计算20年间T2DM患者各种死亡原因的构成比；通过logistic回归及年龄、性别分层方法分析T2DM对恶性肿瘤、缺血性心脏病及脑血管疾病患者病死率的影响.结果 1993年至今,我院住院患有T2DM的患者共47 443例,T2DM患者的比例由4.55％ (609/13 395)逐年上升至11.97％(11 778/98 402),全院死亡患者中T2DM患者的构成比由9.64％(32/332)逐年升至25.47％(149/585),T2DM患者病死率由5.25％ (32/609)逐年下降到1.27％ (149/11 778).我院所有科室T2DM患者死亡原因前五位分别是恶性肿瘤(32.02％)、呼吸系统疾病(17.13％),缺血性心脏病(15.22％)、脑血管疾病(9.75％)和器质性心脏病(5.40％),非T2DM患者的死亡原因前五位是恶性肿瘤(48.07％)、呼吸系统疾病(13.61％)、脑血管疾病(5.63％)、缺血性心脏病(5.57％)和器质性心脏病(4.70％).校正年龄、性别因素后,合并与不合并T2DM的恶性肿瘤、缺血性心脏病、脑血管疾病患者住院期间病死的风险比分别是2.03(95％ CI1.871～2.202)、1.303(1.206 ～1.409)和1.205(1.094～1.327).结论 (1)我院住院患者T2DM的患病率逐年增高,住院期间死亡患者中T2DM患者的构成比逐年增加,但病死率逐渐下降.(2)T2DM患者死亡的主要原因是恶性肿瘤、呼吸系统疾病和心脑血管疾病,合并T2DM的恶性肿瘤、缺血性心脏病、脑血管疾病患者住院期间病死风险增加.

abstractsObjective To analyze retrospectively the causes of death,hospital mortalities and mortality risk in hospitalized patients with and without type 2 diabetes mellitus (T2DM).Methods Informations of all inpatients admitted to PLA General Hospital during 1993 and 2012 were collected and analyzed.Prevalence and mortalities of T2DM among all hospitalized patients and proportion of T2DM patients among total deaths of inpatients each year were calculated.Causes of deaths were analyzed.Logistic regression and stratified analyses of hospital mortalities were performed.Results During the study period of 20 years,the proportion of hospitalized patients with T2DM had risen from 4.55％ (609/13 395)to 11.97％ (11 778/98 402) ; the proportion of T2DM patients among all deaths had risen from 9.64％ (32/332) to 25.47％ (149/585),the hospital mortality of patients with T2DM decreased from 5.25％ (32/609) to 1.27％ (149/11 778).The leading causes of death of patients with T2DM were malignancy (32.02％),respiratory disease (17.13％),ischemic heart disease (15.22％),cerebrovascular disease (9.75％) and organic cardiopathy (5.40％),while the leading causes of death of patients without T2DM were malignancy (48.07％),respiratory disease (13.61％),cerebrovascular disease (5.63％),ischemic heart disease (5.57％) and organic cardiopathy (4.70％).After adjustment for age and sex,T2DM was associated with increased risks of mortality in patients with malignancy (RR 2.03,95％ CI(1.871-2.202)),ischemic heart disease (1.303 (1.206-1.409)) and cerebrovascular disease (1.205 (1.094-1.327)).Conclusions T2DM is associated with increased risks of mortality in patients with malignancy,ischemic heart disease and cerebrovascular disease.As the proportion of inpatients with T2DM increased,the influence of T2DM on hospital mortality deserves more attention.