摘    要：目的:以哈密地区患1型糖尿病儿童为研究对象，探讨其患病危险因素，为有效防治，降低其发病风险提供参考依据。方法:回顾性分析 2012年至2016年间维吾尔族患病儿童及未患病的临床资料，采用单因素和多因素回归分析探讨该地区患病儿童所面临的危险因素。结果：单因素显示，两组患儿年龄、前驱感染、居住地、喂养方式、摄入淀粉类食物时间、摄入高脂肪食物时间、家族史等变量差异存在统计学意义（P<0.05）。多因素显示：较大的年龄、过早摄入淀粉类食物、高热量食物、前躯感染、为1型糖尿病患病的主要危险因素，而母乳喂养是其保护因素。结论：哈密地区维吾尔族儿童1型糖尿病的发病受多因素的影响，避免和减少前驱感染、提倡母乳喂养可降低其发病风险。

Objective: To study the Uighur children with type 1 diabetes in Hami area as an example, to explore the causes of the disease and the hidden dangers of the disease, and to make a corresponding response to the situation of Uighur children with type I diabetes in Hami area. Targeted measures to reduce the chance of illness. Methods:  A retrospective analysis was conducted on the clinical data of Uygur prevalence children and non-affected children from 2012 to 2016. Univariate and multivariate regression analysis were used to investigate the risk factors faced by children with the disease in the area.Results:Univariate showed that there were significant differences in variables such as age, pre-existing infection, place of residence, feeding method, time of intake of starchy foods, intake of high-fat food, and family history among the two groups (P<0.05). Multiple factors showed that older age, premature intake of starchy foods, high-calorie foods, and pre-infections were the major risk factors for type 1 diabetes, and breastfeeding was a protective factor. Conclusion: The incidence of type 1 diabetes in Uighur children in the Hami area is affected by multiple factors. Avoiding or reducing pre-existing infections and promoting breastfeeding can reduce the risk of developing the disease.

关键词：1 型糖尿病；危险因素；维吾尔族；儿童

Keyword: Type 1 Diabetes; Risk Factors; Uighur; Children

目    录

摘    要..2

Abstract.2

1  前言.4

1.1研究背景.4

1.1.1 1型糖尿病的危险因素.4

1.1.2 1型糖尿病的发病生理过程.5

1.2研究目的与意义.7

2材料与方法.7

2.1研究对象.7

2.2纳入标准..8

2.3方法8

2.4统计学分析8

3　结果.8

3.1 调查对象基本情况..8

3.2 病例组和对照组相关危险因素单因素分析.9

3.3 1型糖尿病危险因素多因素分析..10

4　讨论..10

参考文献12

致谢..12

1前言

1.1研究背景

糖尿病是由于胰岛素分泌绝对缺乏或相对不足所致的糖、脂肪、蛋白质代谢紊乱症，长期处于高血糖可以引起许多并发症，如：微血管病变引起视网膜病变导致失明，肾功能障碍甚至肾功能衰竭，神经病变和心脑大血管病变，发生下肢坏疽，心机梗死和脑血管意外等，常导致残疾或过早死亡。绝大部分儿童糖尿病为1型糖尿病，目前考虑是多种原因共同作用于胰岛β细胞，导致胰岛β细胞破坏，最终使得胰岛素分泌绝对不足所致，又称为胰岛素依赖性糖尿病，目前认为是遗传，免疫和环境共同作用所致，是一种免疫反应发生于又遗传倾向的个体，该个体拥有特定的易感性基因，或缺乏具有保护性基因，在环境因素的共同作用下，使胰岛β细胞发生自身免疫性损伤，个体免疫反应失控致病[1]。而1型糖尿病的发病率在各个国家之间的差异较大，即使同一国家，不同民族和地区之间也存在差异。最近的流行病学研究也表明该病的发病率在世界的总趋势逐年增高，而其病死率也高于儿童期其他慢性疾病[2-4]。