目的 分析学龄期1型糖尿病(T1DM)儿童生存质量差异的因素,为制定改善TIDM患儿生存质量的治疗方案提供依据。方法 对2016年6月-2018年6月至西安市中心医院进行治疗的106例学龄期TIDM患儿进行问卷调查,问卷采用郑玲玲等编制的《重庆地区儿童青少年糖尿病患者生存质量调查量表》,观察调查问卷中患儿在影响领域、满意度领域得分,以及总体得分情况。观察不同的空腹血糖、糖化血红蛋白(HbA1c)等指标的患儿问卷得分差异,以及影响患儿生存质量的因素。结果 患儿生存质量量表分为影响领域和满意度领域两部分,106名学龄期T1DM患儿影响领域量表得分为(82.37±11.44)分,满意度领域(25.41±5.77)分,总体得分(110.54±18.89)分。空腹血糖≤6.1 mmol/L患儿的生存质量量表得分(105.16±14.88)明显低于空腹血糖>6.1 mmol/L的患儿(142.26±20.61)(t=10.064,P=0.001);HbA1c≤7.6%患儿的生存质量量表得分(103.67±19.26)明显低于HbA1c＞7.6%的患儿得分(144.58±22.27)(t=9.572,P<0.001)。不同性别、住址、家庭收入的患儿,其生存质量评分差异无统计学意义(P>0.05),但是糖尿病饮食遵守情况、胰岛素注射方式、注射次数、血糖监测次数以及病程会导致生存质量评分差异有统计学意义(P<0.001)。结论 1型糖尿病学龄期儿童的生存质量受多种因素影响,因此对此类儿童应制定严格的饮食方案,采用胰岛素泵进行注射,以维持患儿血糖和糖化血红蛋白在较长时间内的稳定。

Objective To explore the factors influencing the quality of life (QOL) of school-age children with type 1 diabetes mellitus (T1DM),in order to provide reference for improving the QOL of T1DM children. Methods A total of 106 school-age children with T1DM undergoing treatment in Xi'an Central Hospital from were enrolled in this study from June 2016 to June 2018 and were investigated by QOL questionnaires developed by ZHENG Ling-ling.The scores of influence field,satisfaction field and the overall score in children were observed.Differences on questionnaire scores between children with different values of fasting blood glucose and glycosylated hemoglobin (HbA1c) were compared.And the factors influencing QOL of TIDM children were analyzed. Results The QOL scale was divided into two parts,influence domain and satisfaction domain.The average score of 106 school-age children in the influence domain was (82.37±11.44),the satisfaction domain was (25.41±5.77),and the total score was (110.54±18.89).The QOL of children with fasting blood glucose≤6.1 mmol/L was significantly lower than that of children with fasting blood glucose＞6.1 mmol/L (105.16±14.88 vs.142.26±20.61,t=10.064,P=0.001).Meantime,the QOL of children with HbA1c≤7.6% was significantly lower than that of children with HbA1c＞7.6% (103.67±19.26 vs.144.58±22.27,t=9.572,P=0.001).There was no significant differences on QOL among children in different sex,dwelling place and family income groups(P>0.05),but significant differences on QOL were found among children in different dietary compliance,insulin injections,injection times,blood glucose monitoring times and duration of disease groups (P<0.001). Conclusions The QOL of school-age children with T1DM is affected by multiple factors.So strict dietary plan is supposed to be made,and insulin pump is suggested to be used in the injection of T1DM children,so as to keep the fasting blood glucose and HbA1c levels stable.