2型糖尿病患者心血管预防用药评价

Evaluation of Drug Prophylaxis in the Primary and Secondary Prevention of Cardiovascular Events in Patients with Type 2 Diabetes

目的:评价病区2型糖尿病患者心血管预防用药的实际情况,为建立心血管预防用药评估提供实践依据。方法:采取跟踪调查方法,对2017年8月~2018年7月内分泌病区2型糖尿病入院患者264例进行跟踪,通过实施药学服务,评估患者的心血管发病风险及其预防用药达标率。结果:264例患者入院时阿司匹林(ASA)一、二级预防达标率分别为26.42%和96.77%,调脂药物一、二级预防达标率分别为30.17%和65.79%;患者出院时ASA一、二级预防达标率分别为88.05%和96.77%,调脂药物一、二级预防达标率分别为85.47%和98.68%。入院后患者ASA和调脂药物的一级预防达标率有明显提高(P<0.05)。结论:2型糖尿病患者入院后经评估,相对于入院前心血管预防用药明显改善,但仍存在部分人群有预防指征却未用药的情况,提示临床有必要更积极筛查心血管危险因素,建立符合实际情况的心血管预防用药评估,提高预防率。

Objective:To evaluate drug prophylaxis in the primary and secondary prevention of cardiovascular events in inpatients with type 2 diabetes,so as to provide experiences for establishing the evaluation of drug prophylaxis.Methods:By follow-up investigation,the inpatients with type 2 diabetes in endocrine department were followed up by clinical pharmacists and received pharmaceutical care during August 2017 and July 2018,and statistical analysis was conducted on drug usage to evaluate drug prophylaxis.Results:There were 264 patients with follow-up during the year,and the standard-reaching rate for aspirin(ASA)in the primary and secondary prevention of cardiovascular events respectively was 26.42%and 96.77%before hospitalization,and respectively 88.05%and96.77%after hospital discharge.As for hypolipidemic agents,that respectively was 30.17%and 65.79%before hospitalization,and85.47%and 98.68%after hospital discharge.There were statistically significant differences in standard-reaching rates for ASA and hypolipidemic agents in the primary prevention between before hospitalization and after hospital discharge(P<0.05).Conclusion:After hospital discharge,the drug prophylaxis for cardiovascular events in patients with type 2 diabetes can be improved significantly by the assessment on atherosclerotic cardiovascular disease(ASCVD)risk,however,some cases with indications are without drug prophylaxis yet,suggesting that it is necessary to screen the risk factors for ASCVD more positively,and establish realistic assessment for drug prophylaxis in the prevention of cardiovascular events in order to improve the prevention rate.