基于系统动力学的2型糖尿病管理模型构建与初步仿真
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摘要
目的 探索系统动力学模型用于评价2型糖尿病健康管理的可行性,构建适用于本地人口的模型。方法 以2型糖尿病人口动力为研究对象,参考美国疾病预防控制中心相似模型,通过确定边界、绘制流图,编写方程式,构建系统动力学模型,根据徐汇区的情况调整了亚裔人糖尿病的风险比、人口数、患病数、诊断率、管理率等参数后进行模型初始仿真。结果 构建了适用于本地人口的2型糖尿病管理系统模型,初始仿真结果显示,从2010-2020年,徐汇区2型糖尿病患病率将从6.6%上升到11.6%,上升趋势未放缓,同期因病死亡率则从32/10万上升到70/10万,上升趋势有所放缓。结论 系统动力学模型能对2型糖尿病的患病率和因病死亡率等指标进行有条件预测,为评价和调整健康管理机制提供了一种新视角、新方法。
Objective To explore the feasibility of system dynamics model for evaluating the health management of type 2 diabetes, and to build a model suitable for local populations. Methods The population dynamics of type 2 diabetes served as the research subject. Based on a systematic review of a similar mathematical model established by the U.S. Centers for Disease Control and Prevention, a system dynamics model was developed by determining the system boundary, constructing the system flow diagram and outlining the system structure. According to the situation of Xuhui District, the risk ratio, number of population, prevalence, diagnosis rate and management rate of Asian diabetes were adjusted, and then the initial simulation was performed. Results A system dynamics model suitable for the health management of type 2 diabetes in local population was established. The results of the initial simulation revealed that the prevalence rate of type 2 diabetes in Xuhui District from 2010 to 2020 would increase from 6.6% to 11.6%, and the rising trend would not slow down. The mortality rate in the same period would increase from 32/100,000 to 70/100,000, and the rising trend would slow down. Conclusions The system dynamics model can predict the morbidity and mortality of type 2 diabetes, and provide a new perspective and method for the evaluation and adjustment of health management mechanism.
Objective To explore the feasibility of system dynamics model for evaluating the health management of type 2 diabetes, and to build a model suitable for local populations. Methods The population dynamics of type 2 diabetes served as the research subject. Based on a systematic review of a similar mathematical model established by the U.S. Centers for Disease Control and Prevention, a system dynamics model was developed by determining the system boundary, constructing the system flow diagram and outlining the system structure. According to the situation of Xuhui District, the risk ratio, number of population, prevalence, diagnosis rate and management rate of Asian diabetes were adjusted, and then the initial simulation was performed. Results A system dynamics model suitable for the health management of type 2 diabetes in local population was established. The results of the initial simulation revealed that the prevalence rate of type 2 diabetes in Xuhui District from 2010 to 2020 would increase from 6.6% to 11.6%, and the rising trend would not slow down. The mortality rate in the same period would increase from 32/100,000 to 70/100,000, and the rising trend would slow down. Conclusions The system dynamics model can predict the morbidity and mortality of type 2 diabetes, and provide a new perspective and method for the evaluation and adjustment of health management mechanism.
引文
[1]国家卫生计生委疾病预防控制局.中国居民营养与慢性病状况报告(2015年)[M].北京:人民卫生出版社,2015:51-53.
[2]Ripsin CM,Kang H,Urban RJ. Management of blood glucose in type 2diabetes mellitus[J]. Am Fam Physician,2009,79(1):29-36.
[3]Homer JB,Jones AP,Seville D,et al. The CDC's diabetes systems modeling project:developing a new tool for chronic disease prevention and control[EB/OL].(2014-01-01)[2018-10-20]. https://www. researchgate. net/publication/228543463.
[4]Homer JB,Jones AP. Diabetes system model reference guide[EB/OL].(2004-10-01)[2018-10-20].https://www.researchgate.net/publication/241612894.
[5]张彦琦,潘传波,张玲,等.系统动力学方法在慢性病管理中的应用[J].成都医学院学报,2012,7(1):18-21.
[6]王超.中国成人超重和肥胖及主要危险因素对糖尿病发病的影响[D].北京:北京协和医学院,2014.
[7]中华医学会糖尿病分会.中国2型糖尿病防治指南(2013年版)[M].北京:北京大学医学出版社,2015:1-4.
[8]董时广,苏桦,欧阳乐宣,等.社区规范化管理对2型糖尿病的效果评价[J].实用预防医学,2015,22(10):1218-1219.
[9]张坚,王春荣,付萍. 2002年中国城市居民糖尿病流行状况分析[J].中华预防医学杂志,2007,41(1):4-7.
[10]刘敏,刘世炜,王黎君. 1990-2016年中国糖尿病患病和伤残导致负担分析[J].中国慢性病预防与控制,2018,26(12):881-889.
[11]王其藩.高级系统动力学[M].北京:清华大学出版社,1995:3-5.
[2]Ripsin CM,Kang H,Urban RJ. Management of blood glucose in type 2diabetes mellitus[J]. Am Fam Physician,2009,79(1):29-36.
[3]Homer JB,Jones AP,Seville D,et al. The CDC's diabetes systems modeling project:developing a new tool for chronic disease prevention and control[EB/OL].(2014-01-01)[2018-10-20]. https://www. researchgate. net/publication/228543463.
[4]Homer JB,Jones AP. Diabetes system model reference guide[EB/OL].(2004-10-01)[2018-10-20].https://www.researchgate.net/publication/241612894.
[5]张彦琦,潘传波,张玲,等.系统动力学方法在慢性病管理中的应用[J].成都医学院学报,2012,7(1):18-21.
[6]王超.中国成人超重和肥胖及主要危险因素对糖尿病发病的影响[D].北京:北京协和医学院,2014.
[7]中华医学会糖尿病分会.中国2型糖尿病防治指南(2013年版)[M].北京:北京大学医学出版社,2015:1-4.
[8]董时广,苏桦,欧阳乐宣,等.社区规范化管理对2型糖尿病的效果评价[J].实用预防医学,2015,22(10):1218-1219.
[9]张坚,王春荣,付萍. 2002年中国城市居民糖尿病流行状况分析[J].中华预防医学杂志,2007,41(1):4-7.
[10]刘敏,刘世炜,王黎君. 1990-2016年中国糖尿病患病和伤残导致负担分析[J].中国慢性病预防与控制,2018,26(12):881-889.
[11]王其藩.高级系统动力学[M].北京:清华大学出版社,1995:3-5.
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