摘要
目的 探讨汽南社区规范化管理2型糖尿病患者管理现状.方法 采用横断面研究方法,对汽南社区行规范化管理的484例2型糖尿病患者,通过查阅健康档案及门诊就诊病历获取至2016年12月的临床资料.结果 484例患者年龄（71.2±11.2）岁,病程（12.2±7.8）年,BMI（24.76±3.06） kg/m^2,383例患者TC（5.08±3.27）mmol/L、LDL-C（2.72±0.78） mmol/L;其中383例监测静脉空腹血糖,101例监测快速空腹血糖,258例监测糖化血红蛋白.静脉空腹血糖达标率为51.96％（199/383）,糖化血红蛋白达标率为60.08％ （155/258）,快速空腹血糖达标率为51.49％（52/101）.484例中,诊室血压＜ 140/90 mmHg（1 mmHg =0.133 kPa）者389例（80.37％）,BMI达标率36.57％（177/484）.静脉空腹血糖、糖化血红蛋白、LDL-C、血压均达标者46例（17.83％,46/258）.监测静脉空腹血糖的383例中,LDL-C＜2.6 mmol/L者53.79％（206/383）,HDL-C≥1.0 mmol/L者23.24％（89/383）;空腹血糖＜ 7.8 mmol/L者的LDL-C水平低于≥7.8 mmol/L者[（2.67±0.76）与（2.84±0.80） mmol/L],HDL-C水平较高[（1.50±0.88）与（1.33±0.40） mmol/L],差异均有统计学意义（F=4.42,P=0.04;Z=-2.30,P=0.02）.随着病程的延长糖化血红蛋白达标率下降,差异有统计学意义（χ^2=12.57,P＜0.01）.结论 汽南社区规范化管理的2型糖尿患者的综合达标率较低,进行糖尿规范化管理过程中应兼顾血脂、血压、体质量及病程,以提高糖尿病患者的综合达标率.
Objective To evaluate the effectiveness of standardized management for patients with type 2 diabetes in Beijing Qinan community.Methods Total 484 patients with type 2 diabetes in Qinan community were under standardized management.A cross-sectional study on the effectiveness of diabetes management was conducted in December 2016 based on the health records and clinic medical records.Results The mean age was（71.2 ± 11.2） years,the duration of diabetes was （12.2 ± 7.8） years,the mean BMI was（24.76 ± 3.06） kg/m^2 in 484 patients.The TC was（5.08 ± 3.27） mmol/L and LDL-C was（2.72 ±0.78）mmol in 383 patients.The rate of achieving the target level of fasting blood-glucose was 51.96% （199/383）;the rate of achieving glycosylated hemoglobin target was 60.08% （155/258）;and the rate of achieving quick fasting blood-glucose target was 51.49% （52/101）.There were 80.37% （389/484） patients with clinic blood pressure 〈 140/90 mmHg（1 mmHg =0.133 kPa）,36.57% patients （177/484） had normal BMI;and 17.83% patients （46/258） with controlled clinic blood pressure,fasting blood glucose,glycosaylated hemoglobin and LDL-C.There were 53.79% patients with LDL-C 〈 2.6 mmol/L and 23.24% with HDL-C ≥ 1.0 mmol/L.The patients with fasting glucose 〈 7.8 mmol/L had lower LDL-C than the patients with fasting glucose ≥ 7.8 mmol/L,（F =4.42,P =0.04）,The patients with fasting glucose 〈 7.8mmol/L had higher HDL-C than the patients with fasting glucose ≥ 7.8 mmol/L （Z =-2.30,P =0.02）.The rate of achieving glycosylated hemoglobin target was decreased with the increasing of disease duration （χ^2 =12.57,P =0.01）.Conclusion The comprehensive target-reaching rate of type 2 diabetes patients with standardization management in Qinan community is relatively low.It is necessary to strengthen the control of blood lipid,body weight and blood pressure for improving the effectiveness of standardized management of diabetic patients.
作者
边立立
侯武姿
董玉明
宋贝贝
赵红英
李晶
赵素琴
Bian Lili, Hou Wuzi, Dong Yuming, Song Beibei, Zhao Hongying, Li Jing, Zhao Suqin(Yuetan Community Health Service Center of Fuxing Hospital Affiliated to Capital Medical University, Beijing 100045, Chin)
出处
《中华全科医师杂志》
2018年第5期410-413,共4页
Chinese Journal of General Practitioners
关键词
糖尿病
2型
社区卫生服务
横断面研究
病例管理
Diabetes mellitus
type 2
Community health services
Cross-sectional studies
Case management
