药学服务对社区老年慢性病患者尿酸、血糖、糖化血红蛋白及血脂的影响

Effects of pharmaceutical care on the levels of uric acid, blood glucose, glycosylated hemoglobin and blood lipid in elderly patients with chronic diseases in community

目的研究药学服务对社区老年慢性病患者尿酸(UA)、血糖、糖化血红蛋白(Hb A1c)及血脂的影响。方法采取整群抽样的方法抽取上海市嘉定区真新地区4个社区60~75岁患有多种慢性病老年人128例,分成两组,分二期干预,比较干预组(n=63)及对照组(n=65)患者UA、血糖、血脂指标的差异,分析药学服务效果。结果第一期干预后(干预6个月),干预组UA、空腹血糖(FBG)、Hb A1c、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白-胆固醇(LDL-C)下降,高密度脂蛋白-胆固醇(HDL-C)升高(P<0.01),对照组FBG、Hb A1c、LDL-C下降,HDL-C升高(P<0.05或P<0.01);除UA外,两组其他指标干预前后变化值组间比较差异有统计学意义(P<0.01)。第二期干预后(干预12个月),两组FBG、Hb A1c、TG、TC、LDL-C下降,HDL-C升高(P<0.01);两组FBG、Hb A1c、TC、HDL-C、LDL-C干预前后变化值差异具有统计学意义(P<0.01)。结论药学服务可明显改善社区老年慢性病患者的血糖、血脂水平,值得推广。

Objective To study the effect of pharmaceutical care on the levels of uric acid（UA）, blood glucose, glycosylated hemoglobin（Hb A1 c） and blood lipid in elderly patients with chronic diseases in community. Methods A total of 128 elderly patients（aged 60-75 years old） with chronic diseases in 4 communities in Zhenxin were recruited into the study by using cluster sampling. They were divided into two groups, through two stages of pharmaceutical care intervention, and the differences in UA, blood glucose and blood lipids were compared between the patients of the intervention group（n=63） and the control group（n=65）. Results After first phase of the intervention（6 months of intervention）, the UA, fasting blood glucose（FBG）, Hb A1 c, triglyceride（TG）, total cholesterol（TC）, and low density lipoprotein-C（LDL-C） in intervention group were decreased, and high density lipoprotein-C（HDL-C） was increased, which were better than those in control group（P〈0.05 or P〈0.01）. After second phase of intervention（12 months of intervention）, the FBG, Hb A1 c, TG, TC, LDL-C in two groups were decreased, and HDL-C was increased, the differences were statistically significant（P〈0.01）. However, before and after intervention, the changes of FBG, Hb A1 c, TC, HDL-C, and LDL-C were statistically significant（P〈0.01）. Conclusion Pharmaceutical care can significantly improve the level of blood glucose and blood lipid control in elderly patients with chronic diseases in community.