社区糖尿病合并高血压老年患者的用药情况及疗效评价

Medicine prescriptions and clinical efficacy of elderly diabetic patients complicated with hypertension in community health service centers

目的评估社区老年人糖尿病合并高血压的用药情况及其疗效,为社区签约糖尿病合并高血压患者合理用药提供参考。方法回顾性分析2021年1月至3月上海市松江区小昆山镇社区卫生服务中心355例糖尿病合并高血压患者的用药情况及其疗效。355例患者中男132例、女223例,年龄(77.98±5.42)岁。结果全部案例中降糖药物排名前5位:磺脲类占60.6%(215/355),双胍类占48.5%(172/355),α-糖苷酶抑制剂类占37.5%(133/355),胰岛素占14.4%(51/355),噻唑烷二酮类占7.6%(27/355)。降压药物排名前5位:钙离子拮抗剂占67.0%(238/355),血管紧张素Ⅱ受体拮抗剂(ARB)占61.1%(217/355),β-受体阻滞剂占6.7%(24/355),血管紧张素转换酶抑制剂(ACEI)占4.2%(15/355),利尿剂占3.9%(14/355)。血糖达标占89.3%(317/355),血糖未达标占10.7%(38/355)。血压达标占84.2%(299/355),血压未达标占15.8%(56/355)。结论社区老年人糖尿病合并高血压的用药情况基本合理,病情控制基本稳定,但存在药物治疗跟踪评估的欠缺及部分疗效不达标、用药不合理的情况。

Objective To investigate the medicine prescriptions and clinical efficacy in elderly diabetic patients complicated with hypertension in community health service centers,and to provide references for the rational drug use for those patients in community health service centers.Methods The medicine prescriptions and clinical efficacy in 355 elderly diabetic patients complicated with hypertension treated at Xiaokunshan Community Health Service Center from January to March 2021 were retrospectively analyzed.Among the 355 patients,there were 132 males and 223 females,and they were(77.98±5.42)years old.Results The top 5 hypoglycemic agents for the 355 patients were sulfonylureas[60.6%(215/355)],biguanides[48.5%(172/355)],α-glycosidaseinhibitors[37.5%(133/355)],insulin[14.4%(51/355)],and thiazolidinediones[7.6%(27/355)],and the top 5 antihypertensive drugs were calcium antagonists[67.0%(238/355)],angiotensin Ⅱ receptor antagonists(ARB)[61.1%(217/355)],β-receptor blockers[6.7%(24/355)],angiotensin converting enzyme inhibitors(ACEI)[4.2%(15/355)],and diuretics[3.9%(14/355)].The blood glucose qualified rate was 89.3%(317/355),and the unqualified rate 10.7%(38/355).The blood pressure qualified rate was 84.2%(299/355),and the unqualified rate 15.8%(56/355).Conclusion The drug administration of elderly diabetic patients complicated with hypertension is reasonable in the community,and their disease condition control is basically stable,but some treatment cannot be followed and evaluated,some treatment effect is not qualified,and some irrational drug use is also found.