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东日本大地震及巨大海啸对糖尿病患者血糖控制和血压的影响。

Effects of the Great East Japan Earthquake and huge tsunami on glycaemic control and blood pressure in patients with diabetes mellitus.

作者信息

Ogawa Susumu, Ishiki Mikihito, Nako Kazuhiro, Okamura Masashi, Senda Miho, Sakamoto Takuya, Ito Sadayoshi

机构信息

Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Hospital, Sendai, Japan.

出版信息

BMJ Open. 2012 Apr 13;2(2):e000830. doi: 10.1136/bmjopen-2012-000830. Print 2012.

Abstract

OBJECTIVE

To examine the effects of a huge tsunami resulting from the Great East Japan Earthquake on blood pressure (BP) control and glycaemic control in diabetic patients.

DESIGN

A retrospective study.

SETTING

Tohoku University, Japan.

PARTICIPANTS

63 patients were visiting Rikuzentakata Hospital for diabetic treatment before the earthquake and returned to the clinic in July after the earthquake, and they were analysed in the present study. The subjects were divided into two groups: those who were hit by the tsunami, the Tsunami (+) group (n=28), and those who were not, the Tsunami (-) group (n=35), and the groups' parameters and their changes were compared.

PRIMARY OUTCOME MEASURE

Changes of HbA1c.

SECONDARY OUTCOME MEASURES

Changes of BP, body mass index.

RESULTS

HbA1c and both BP increased, while the numbers of most drugs taken decreased in both groups. Parameter changes were significantly greater in the Tsunami (+) group. All medical data stored at the hospital was lost in the tsunami. The Tsunami (+) patients also had their own records of treatment washed away, so it was difficult to replicate their pre-earthquake drug prescriptions afterwards. In comparison, the Tsunami (-) patients kept their treatment information, making it possible to resume the treatment they had been receiving before the earthquake. The BP rose only slightly in men, whereas it rose sharply in women, even though they had not been directly affected by the tsunami. BP rose markedly in both genders affected by the tsunami.

CONCLUSIONS

All medical information was lost in the tsunami, and glycaemic and BP controls of the tsunami-affected patients worsened more than those of patients who had been affected by the earthquake alone. Women may be more sensitive to changes in the living environment that result from a major earthquake than are men.

摘要

目的

研究东日本大地震引发的巨大海啸对糖尿病患者血压(BP)控制和血糖控制的影响。

设计

一项回顾性研究。

地点

日本东北大学。

参与者

63例患者在地震前到陆前高田医院接受糖尿病治疗,地震后于7月返回诊所,本研究对他们进行了分析。受试者分为两组:受海啸影响的患者,即海啸(+)组(n = 28),以及未受影响的患者,即海啸(-)组(n = 35),比较两组的参数及其变化。

主要观察指标

糖化血红蛋白(HbA1c)的变化。

次要观察指标

血压、体重指数的变化。

结果

两组患者的HbA1c和血压均升高,而大多数药物的服用量减少。海啸(+)组的参数变化明显更大。医院存储的所有医疗数据在海啸中丢失。海啸(+)组患者自己的治疗记录也被冲走,因此事后难以复制他们地震前的药物处方。相比之下,海啸(-)组患者保留了他们的治疗信息,从而有可能恢复他们在地震前接受的治疗。男性血压仅略有上升,而女性血压急剧上升,尽管她们没有直接受到海啸影响。受海啸影响的男女血压均显著上升。

结论

所有医疗信息在海啸中丢失,受海啸影响患者的血糖和血压控制比仅受地震影响的患者恶化得更严重。女性可能比男性对大地震导致的生活环境变化更敏感。

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