医院健康管理模式在糖尿病前期人群中的应用

Application of hospital health management mode in patients with pre-diabetes

目的 探讨医院健康管理模式在糖尿病前期人群中的实施效果.方法 从2011年4-6月在健康体检中心体检的人群中随机抽取处于糖尿病前期的80人,分为研究组和对照组各40人.研究组采用自行设计的医院健康管理模式管理,对照组采用传统的管理模式.在入组时、入组6个月、1年后分别对两组的糖尿病知识的知晓率、FPG、2hPG、SBP、DBP、LDL、BMI等进行评价;并比较1年后糖尿病转化率.结果 入组6个月后,研究组人群糖尿病知识的知晓率为91.89％,FPG（5.68±0.43） mmol/L、2 hPG（9.63±0.67） mmol/L、SBP（117.4±07.40） mmHg、DBP（72.9±05.10） mmHg,对照组分别为44.74％,（6.84±1.32） mmol/L,（10.75±0.91） mmol/L,（125.60±10.20） mmHg,（77.3±06.91） mmHg,两组比较差异具有统计学意义（x2=19.156,t值分别为5.030 6,2.285 2,3.955 4,2.615 2;P ＜0.05）;LDL、BMI均有下降趋势,但两组比较差异无统计学意义（P＞0.05）;1年后,研究组的FPG、2hPG、SBP、DBP、LDL、BMI均较对照组降低,差异均有统计学意义（P＜0.05）;研究组和对照组糖尿病转化率分别为2.7％（1/37）和15.8％（6/38）,研究组明显低于对照组,差异具有统计学意义（x2=2.405 1,P＜0.05）.结论 采用自行设计的糖尿病前期医院健康管理模式可提高糖尿病前期人群的糖尿病知识知晓率,降低FPG、2hPG、SBP、DBP、LDL、BMI,减少糖尿病转化率.

Objective To explore the effect of hospital health management mode in patients with prediabetes.Methods Eighty pre-diabetes patients who were randomly chosen from physical examination people in the physical examination center of our hospital from April 2011 to June 2011 were divided into the observation group and the control group.The observation group received the hospital health management mode of pre diabetes designed by ourselves,and the control group received the traditional management mode.The awareness rate of diabetes in patients with pre-diabetes,the fasting plasma glucose （FPG）,2 h postprandial plasma glucose （2 h PG）,systolic blood pressure （SBP）,diastolic blood pressure （DBP）,low-density lipoprotein （LDL）,body mass index （BMI） were evaluated at the beginning of the study,six month after the study and one year after the study.The conversion rate of diabetes was compared one year after the study.Results The awareness rate of diabetes in patients with pre-diabetes,the levels of FPG,2 h PG,SBP and DBP were respectively（5.68 ± 0.43） mmol/L,（9.63 ± 0.67） mmol/L,（117.40 ± 7.40） mmHg,（72.90 5.10） mmHg in the observation group,and were （6.84 ± 1.32） mmol/L,（10.75 ±0.91） mmol/L,（125.60 ± 10.20） mmHg,（77.30 6.91） mmHg in the control group,and the differences were statistically significant （x2 =19.156,t =5.030 6,2.285 2,3.955 4,2.615 2,respectively; P 〈 0.05）.The levels of LDL and BMI in the observation group showed a downward trend,but no differences were found in two groups （P 〉 0.05）.One year after the study,the levels of FPG,2 h PG,SBP,DBP,LDL and BMI in the observation group were respectively （5.57 0.38） mmol/L,（9.51 ±0.47） mmol/L,（116.2±37.93） mmHg,（70.4±4.3） mmHg,（3.00±0.37） mmol/L and （23.4 ±2.48）kg/m2,and were lower than （6.91± 1.15） mmol/L,（10.86±3.21） mmol/L,（128.3± 12.14） mmHg,（79.2± 9.56） mmHg,（3.6 ±0.41） mmol/L and （27 ±5.41） kg/m2 in the control group,and the differences were statistically significant （P 〈0.05） ; the conversion rate of diabetes was 2.7% （1/37）in the observation group,and was lower than the 15.8% （6/38） in the control group,and the difference was statistically significant （x2 =2.405 1,P 〈 0.05）.Conclusions The hospital health management mode of pre diabetes designed by ourselves can improve the awareness rate of diabetes in patients with pre-diabetes,decrease the level of FPG,2hPG,SBP,DBP,LDL and BMI,and reduce the conversion rate of diabetes.