北京地区不同等级医院2型糖尿病综合干预治疗前后达标率调查

The standard rate investigation of type 2 diabetes mellitus in different grade hospitals in Beijing before and after comprehensive intervention

目的比较北京地区不同等级医院2型糖尿病综合干预治疗前后血糖、血脂、血压等指标的达标情况。方法对参与本研究项目的医师进行糖尿病知识新进展集中培训,规范糖尿病治疗方案,对入选患者进行糖尿病知识的普及教育。6个月后收集综合干预后相关资料,进行血糖、血脂、血压达标率的数据统计及综合干预前后结果对比分析。结果 36家不同等级医院对糖尿病综合干预后各项指标达标率均有不同程度的提高,与综合干预前比较:一级医院糖尿病患者空腹血糖(FPG)达标率提高17.27%(P<0.01);二级医院糖尿病患者糖化血红蛋白(HbA1c)、FPG、餐后2h血糖(2hPPG)、总胆固醇(TC)、收缩压(SBP)达标率分别提高7.37%、11.16%、8.13%、12.14%、8.60%(P均<0.01);三级医院糖尿病患者HbA1c、FPG、2hPPG达标率分别提高12.87%、10.56%、8.20%(P均<0.01),高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)达标率分别提高4.05%、5.21%(P<0.05)。一级医院按时服药、主动检测血糖者分别增加7.40%及13.15%(P均<0.01);二、三级医院合理饮食和适量运动者分别增加7.04%、9.22%及8.19%、11.22%(P均<0.01);接受联合药物治疗、主动监测血糖者分别增加4.15%、5.72%(P<0.01);不监测血糖者减少3.4%(P<0.01)。结论医师不断接受糖尿病新进展的继续教育,对提高其临床诊治能力和水平十分必要。努力促进患者发挥自我管理的作用,对糖尿病患者积极稳妥控制血糖的同时,应认真筛查可能存在的其他危险因素并予以积极有效的综合干预。

Objective Compare the standard rate of blood pressure, blood glucose and lipid before and after comprehensive intervention of Type 2 Diabetes Mellitus in different grade hospitals in Beijing. Methods The doctors who participated in this research project were intensively trained for the new progress in the diabetes mellitus knowledge. The therapeutic regimen of diabetes mellitus were standardized. The chosen patients were all educated for the diabetes mellitus knowledge. Collect the related information of comprehensive intervention after 6 months were collected so as to analyse the standard rate of blood pressure,blood glucose and lipid and compare the results before and after comprehensiv intervention. Results After the comprehensive intervention in 36 different grade hospitals,the standard rate of each indicator was all improved to different extent. Compared with the results before the comprehensiv intervention,the standard rate of FPG of patients in grade I hospitals was increased by 17.27%（P0.01）. The standard rate of HbA1c,FPG,2hPPG,TC and SBP of patients in grade Ⅱ hospitals was respectively increased by 7.37%,11.16%,8.13%, 12.14% and 8.60%（P0.01）. Likewise in grade III hospitals these indicators＇ standard rate were respectively increased by 12.87%, 10.56%,8.20%（P0.01）while the standard rate of HDL-C and LDL-C was increased by 4.05% and 5.21%（P0.05）. The patients who took medicine on time and tested blood glucose initiatively in grade I hospitals were increased by 7.04% and 13.15%（P0.01）; The patients who maintained resonable diet and regular exercise in grade Ⅱ and Ⅲ hospitals were respectively increased by 7.04%, 9.22% and 8.19%,11.22%（P0.01）;The patients who accepted the combined medication therapy and initiative blood glucose testing were increased by 4.15% and 5.72%（P0.01）;Inversely,the patients that didn＇t test blood glucose were decreased by 3.4%（P0.01）. Conclusions It＇s essential for the doctors to continuously study the new progress of diabetes mellitus knowledge as to improve their abilities and levels of clinical diagnosis and treatment,promote patients＇ initiative of self-management. The other possible risks should also be checked out and intervened actively and effectively,while controling the blood glucose actively and steadily.