北京社区医院与三甲医院共同管理的2型糖尿病达标率动态变化

Dynamic Changes of the Control Rate in Type 2 Diabetes Patients Managed by Community Hospital and Tertiary Hospital Jointly in Beijing

目的:分析北京劲松社区医院与北京三甲医院联合管理社区2型糖尿病(T2DM)患者的5年达标动态效果。方法:劲松社区441例T2DM患者随机分为强化管理组(强化组,n=220)和标准管理组(标准组,n=221);分别采用不同连续联合管理5年,比较两组管理前后各相关指标和联合达标率,以及不同年份两组各指标达标率变化。结果:管理前两组间除舒张压(DBP)外,其它各指标既空腹血糖(FPG)、糖化血红蛋白(HbA1c)、收缩压(SBP)和低密度脂蛋白胆固醇(LDL-C))达标率比较均无统计学意义(P>0.05),联合管理后,两组组间各项指标达标率和联合达标率均明显高于管理前(P<0.01),强化组5年联合达标率(40.91%)显著高于标准组(32.13%)(P<0.05);强化组FPG、HbA1c、血压达标率分别为从54.09%到72.27%、40.00%到70.09%、68.18%到86.81%,也显著高于标准组(P<0.01)。结论:社区医院与三甲医院联合管理模式可有效提高T2DM患者达标率。

Objective：To explore the dynamic effects of 5years outcome rate of patients with type 2diabetes who was joint managed by jinsong community and tongren hospital.Method：441patients with type 2diabetes in Jinsong community were randomly divided into to the intensive group（n=220）and the standard group（n=221）randomly.They were managed by unified model respectively for five years.The changes in the indicators and the joint standard-achieving rate were compared before and after 5years’ treatment.Results：There were no significant differences in compliance rates between the two groups before comprehensive management（P〉0.05）.After comprehensive management,the joint standard-achieving rate in the intensive group control increased from 2.73%to 40.91%,which was significantly higher than that in the standard group（32.13%）.The control rates of fasting plasma glucose,glycolated hemoglobin and blood pressure in the intensive group were increased from 54.09%to 72.27%,40.00%to 70.90% and 68.18%to 86.81%,respectively which were significanlly higher than that of standard group（P〈0.01）.The differences were statistically significant.Conclusion：The joint management mode of community hospitals and 3Ahospitals could improve the standard-achieving the patients with type 2diabetes.