2型糖尿病患者调脂药物应用调查及临床药师干预效果

Investigation of antihyperlipidemic drug usage in patients with type 2 diabetes mellitus and intervention effect of clinical pharmacists

目的分析2型糖尿病(type 2 diabetes mellitus,T2DM)患者调脂药物应用现状,并观察临床药师干预的效果。方法选取T2DM患者90例,分析患者的基本情况、心血管危险程度及调脂药物应用现状,并根据是否有临床药师参与指导分为干预组(n=54)及对照组(n=36),对照组使用常规用药指导,干预组使用临床药师参与的用药指导。比较2组用药依从性、干预前后控制情况及并发症发生情况。结果90例T2DM患者中,低风险患者2例,较高风险患者20例,极高风险患者68例;88例患者需要使用调脂药物(97.78%),79例患者已使用调脂药物(87.78%),使用他汀类药物64例(阿托伐他汀50例,瑞舒伐他汀钙13例),使用非诺贝特9例;干预组的用药依从优良率(94.44%)高于对照组(80.56%),P<0.05;干预组干预后空腹血糖(the fasting blood glucose,FPG)、餐后2 h血糖(2-hour postprandial blood glucose,2 hFPG)、糖化血红蛋白(glycated hemoglobin,HbA1c)、总胆固醇(total cholesterol,TC)和三酰甘油(triglyceride,TG)均低于对照组(P<0.05)。结论T2DM患者调脂药物使用率较高,主要以他汀类调脂药物为主,临床药师干预能有效提升患者的用药依从性,有利于控制患者的血糖及血脂。

Objective To analyze the current status of antihyperlipidemic drug usage in patients with type 2 diabetes mellitus(T2DM)and observe the intervention effect of clinical pharmacists.Methods A total of 90 patients with T2DM were enrolled to analyze their basic conditions,cardiovascular risk degree and current status of antihyperlipidemic drugs usage.According to presence or absence of the guidance from clinical pharmacists,they were divided into intervention group(n=54)and control group(n=36).The control group was given routine medication guidance,while the intervention group was given medication guidance with clinical pharmacist participation.The medication compliance,control situations before and after intervention and complications in the 2 groups were compared.Results Among the 90 patients with T2DM,there were 2 cases,20 cases and 68 cases with low risk,high risk and extremely high risk,respectively.There were 88 cases(97.78%)needing antihyperlipidemic drugs and 79 cases(87.78%)having used antihyperlipidemic drugs.There were 64 cases treated with statin antihyperlipidemic drugs(atorvastatin:50 cases,rosuvastatin calcium:13 cases)and 9 cases treated with fenofibrate.The medication compliance in intervention group was better than that in control group(94.44%vs.80.56%,P<0.05).After intervention,the fasting blood glucose(FPG),2-hour postprandial blood glucose(2 hFPG),glycated hemoglobin(HbA1c),total cholesterol(TC)and triglyceride(TG)in intervention group were lower than those in control group(P<0.05).Conclusion The usage rate of antihyperlipidemic drugs is high in T2DM patients,mainly statin antihyperlipidemic drugs.Clinical pharmacist intervention can effectively improve the medication compliance of patients,which is beneficial to control blood glucose and blood lipid.