7356例门诊2型糖尿病患者的病情控制分析

Analysis of Clinical Control of Type 2 Diabetes in 7356 Outpatients

目的 研究门诊2型糖尿病（T2DM）患者的病情控制状况，并分析相关影响因素。方法 按照2002年亚太地区T2DM政策小组推荐的控制目标值，计算内分泌科糖尿病数据库中在库1年以上T2DM患者（A组，n=7356）、建库初期患者（B组，n=1084）以及坚持每月随访患者（C组，n=1367）的血糖、血脂、血压及体质量指数（BMI）的控制达标率，并进行统计学分析比较；同时抽取其中部分患者进行问卷调查，了解影响患者病情控制的相关因素。结果 A组患者共7356例，其糖化血红蛋白（HbAlc）、血压、血脂和BMI控制达标率分别为30％、25．8％、32．6％～81．3％和50．9％；除高密度脂蛋白（HDL）外，其余指标的达标率均高于B组患者相应数值；C组患者共1367例，其主要指标的达标率明显优于A组和B组。问卷调查显示，影响患者病情控制的主要因素包括疾病相关知识的掌握程度低、健康教育的缺乏及有限的专科人才等。结论 绝大多数T2DM患者的病情控制远未达到理想的控制目标，建立和应用科学的疾病管理系统是改善和控制现状的有效方法。

Objective To study the current status of clinical control of outpatients with type 2 diabetes mellitus, and to discuss the factors influencing on disease control. Methods According to the clinical targets recommended by Asian-Pacific Type 2 Diabetes Policy Group, we calculated the success rates of blood glucose, lipid profile, blood pressure and body mass index （BMI） of patients who hospitalized in our department for more than one year（ group A, n = 7 356） , and compared these results with the corresponding rates calculated based on the earlier database （ group B, n = 1 084）. The success rates of metabolic indexes of patients who insisted on hospitalizing monthly （group C, n = 1 367）were calculated. Besides, the factors influencing disease control were discussed through questionnaire. Results There were 7356 patients in group A, and the success rates of HbAlc, blood pressure, blood lipid profile and BMI were 30% , 25.8% , 32.6%-81.3% and 50.9% , respectively. Except for the parameter of high-density lipoprotein, the other rates were higher than the responding ones of group B. There were 1367 patients in group C, and the success rates of main metabolic indexes were higher than those of group A and B. The result of the question- naire indicated that poor understanding of diatetes, lack of health education, and relative scarcity of diplomate were the main factors that influenced the disease control. Conclusion The disease control of most of the type 2 patients with diabetes are far from satisfaction. The application of scientific disease care system is effective for improving the disease control.