糖化血红蛋白控制达标的2型糖尿病患者用药状况分析

Utilization of hypoglycemic agents in type 2 diabetic patients with wellcontrolled glycosylated hemoglobin

目的了解控制达标的2型糖尿病患者用药情况,为临床合理用药提供参考。方法对334例糖化血红蛋白(HbA_(lc))≤6.5%的2型糖尿病患者行空腹血糖、C肽测定,同时调查糖尿病药物用药情况,对药物的分布及频率进行分析。结果 334例HbA_(lc)达标的患者中,使用频率最高的药物是糖苷酶抑制剂(49.7%)。全部患者中有56.6%(189/334)进行了联合用药。最常见的联合用药方案是:预混胰岛素+糖苷酶抑制剂(10.5%)及磺脲类+糖苷酶抑制剂(9.9%)。根据使用胰岛素与否,行多元回归分析发现:使用胰岛素与糖尿病病程正相关,与空腹C肽水平成负相关(均P<0.01)。结论 HbA_(lc)控制达标的患者多数需要联合用药。糖尿病病程越长,C肽水平越低,越需要使用胰岛素。

AIM To investigate the utilization of hypoglycemic agents in type 2 diabetic patients with well-controlled glycosylated hemoglobin Axe （HbA1c）. METHODS A total of 334 type 2 diabetic patients with HbA1c 6.5% were enrolled in the study. The case history, physical examination and biochemical tests were conducted. Fasting plasma glucose and C-peptide were tested. The usage of hypoglycemic agents was summarized and analyzed in respect of category, amount, frequency and combined use. RESULTS Of all the drugs prescribed, the glycosidase inhibitors ranked the first （49.7%）. The combination of hypoglycemic agents was 56.6% （189 patients） of total patients. Of all the combination of hypoglycemic agents, mixtard insulin combined with glycosidase inhibitors （10.5%） and sulfonylureas combined with glycosidase inhibitors （9.9%） ranked the first two places in terms of the medication frequency. Multiple logistic regression analysis confirmed that the duration of diabetes correlated positively, while fasting C-peptide correlated inversety with me usage of insulin（both P 〈 0.01）. CONCLUSION In type 2 diabetic patients With well-controlled HbA1c, the combination of hypoglycemic agents is common. Longer duration of diabetes and lower level of fasting C-peptide will be the risk factors of insulin using.