基于数据挖掘的2型糖尿病肾病患者口服降糖药物用药规律分析

The rule analysis of oral hypoglycemic drugs in patients with type 2 diabetic nephropathy based on data mining

目的:分析2型糖尿病肾病患者口服降糖药物用药规律,为临床治疗2型糖尿病肾病合理用药提供线索。方法:应用山西医科大学第一医院医疗大数据平台检索2009年—2017年住院的2型糖尿病肾病患者临床资料,采用频数、关联规则等数据挖掘方法对2型糖尿病肾病患者口服降糖药物用药规律进行分析。结果:共检索到856例2型糖尿病肾病患者临床资料,频数分析结果显示,2型糖尿病肾病患者口服降糖药以α-糖苷酶抑制剂(阿卡波糖)及双胍类(二甲双胍)为主,格列奈类(瑞格列奈)其次。按肾病分期分析显示,Ⅰ~Ⅲ期患者口服降糖药用药频率与总体一致,而Ⅳ~Ⅴ期患者则以α-糖苷酶抑制剂(阿卡波糖)为主,双胍类使用较少。药物关联规则分析结果显示,阿卡波糖、二甲双胍及瑞格列奈用药关联性较强,支持度从高到低依次为二甲双胍→阿卡波糖、瑞格列奈→阿卡波糖。结论:2型糖尿病肾病Ⅰ~Ⅲ期患者口服降糖药以α-糖苷酶抑制剂(阿卡波糖)及双胍类(二甲双胍)为主,而Ⅳ~Ⅴ期患者则以α-糖苷酶抑制剂(阿卡波糖)为主,双胍类使用较少;阿卡波糖常与二甲双胍或瑞格列奈联用,可协同降糖,延缓肾病进展。

Objective:To analyze the regularity of oral hypoglycemic drugs in patients with type 2 diabetic nephropathy,and to provide clues for the rational use of clinical treatment of type 2 diabetic nephropathy.Methods:The medical big data platform of the First Hospital of Shanxi Medical University was used to retrieve the case data of patients with type 2 diabetic nephropathy who were hospitalized from 2009 to 2017.Data analysis methods such as frequency analysis and association rule analysis were used to analyze the oral hypoglycemic drugs of patients with type 2 diabetic nephropathy.Results:A total of 856 patients with type 2 diabetic nephropathy were retrieved.The frequency analysis showed that the oral hypoglycemic drugs in patients with type 2 diabetic nephropathy were mainlyα-glucosidase inhibitors(acarbose)and biguanides(metformin),followed by Lenin(Riglinide).According to the stage analysis of nephropathy,the frequency of oral hypoglycemic drugs in patients with stageⅠ~Ⅲwas consistent with the overall,while the patients with stageⅣ~Ⅴwere mainlyα-glucosidase inhibitors(acarbose),and the biguanides were less used.The results of drugs association rule analysis showed that acarbose,metformin and repaglinide were highly correlated,and the order of support from high to low was metformin→acarbose,repaglinide→acarbose.Conclusion:The mainly use of oral hypoglycemic drugs in type 2 diabetic nephropathy patients with stageⅠ~Ⅲareα-glucosidase inhibitors(acarbose)and biguanides(metformin),while patients with stageⅣ~Ⅴareα-glucosidase inhibitors(Acarbose),and the biguanides are less used;Acarbose is often used in combination with metformin or repaglinide to synergize with hypoglycemic and delay the progression of kidney disease.