社区医院2型糖尿病患者管理现况研究

摘要

Objective To investigate the situation of T2DM patients in community management, to evaluate the difference of therapeutic effect in patients with different age groups and educational backgrounds, and to provide evidence for improving therapeutic effect of community management. Methods Two hundreds and fifty-four T2DM patients were collected in this study. All patients were from the Medical clinic of some community health service centers in Nanjing from June 2015 to October 2015. Research content includes general condition, medical history of T2DM, treatment information and biochemi-cal test were recorded. It was analyzed that the difference of therapeutic effect in patients with different age groups and ed-ucational backgrounds. Results The Compliance rate of the glycemic and the HbA1c in the patients with College and above group of T2DM w better than the patients with College following groups in FPG (P<0.01), 2h PBG (P<0.01) and HbA1c(P<0.01). The Compliance rate of the glycemic and and the HbA1c in the patients who lied in 25~45 age group were better than the patients who lied in > 65 age group in FBG(P<0.01), 2 h PBG(P<0.01) and the HbA1c(P<0.05). The Com-pliance rate of the glycemic in the patients who lied in 46~65 age group were better than the patients who lied in > 65 age group in FPG (P<0.05),2 h PBG (P<0.01). Conclusion The Compliance rate of the glycemic and the HbA1c in the patients of T2DM with College and above group、25~45 age group and 46~65 age group were better than the patients with College following groups and >65 age group. So, the doctors in community hospital should enhance the education and guide to pa-tients with T2DM, especially to elderly patients with lower education.%目的：探讨2型糖尿病(T2DM)患者社区管理模式下血糖达标的现状，为进一步提高社区管理成效提供依据。方法连续性纳入2015年6-10月在南京部分社区卫生服务中心门诊就诊的，符合纳入标准的254例 T2DM患者，详细记录患者的一般情况、病史资料、治疗信息、生化检验等临床资料。比较不同学历背景和不同年龄组T2DM患者的治疗效果差异。结果大专及以上学历组T2DM患者的血糖控制率和糖化血红蛋白控制达标率，明显高于大专以下学历组患者(空腹血糖P<0.01；餐后2 h血糖P<0.01；糖化血红蛋白P<0.01)。25~45岁组患者空腹血糖达标率、餐后2 h血糖达标率明显升高于>65岁年龄组(P<0.01)；46~65岁组空腹血糖达标率明显高于>65岁年龄组(P<0.05)；46~65岁组餐后2 h血糖达标率明显高于>65岁年龄组(P<0.01)。25~45岁组糖化血红蛋白达标率明显高于>65岁年龄组(P<0.05)。结论 T2DM患者的血糖控制率和糖化血红蛋白达标率，高学历背景患者及青壮年患者明显高于低学历背景的患者及老年患者，社区医院在T2DM慢病管理方面，应坚强对低学历背景及老年患者的综合监护及健康教育，从而改善T2DM患者的远期预后。