2型糖尿病患者糖化血红蛋白监测结果分析

摘要

Objective To understand the control status of hemoglobin A1c (HbA1c) and analyze the relationship with glycemic control and treatment schedule. Methods The study was adopted the method of cross-sectional survey to collect the da-ta of age,diabetes duration and therapeutic management with hypoglycemic agent by questionnaire. The specimens were taken for determination and analysis of HbA1c,blood glucose,blood lipid and so on. Totally 322 patients with type 2 diabetes mellitus (T2DM) were selected with the average age of (55.80±13.36) years and the mean disease course of (3.41±5.18) years. Results (1)The overall glycemic control status:the patients with HbA1c<7% accounted for 34.06%(110/323),the HbA1c of other 65.94%respondents(213/323) failed to reach the control standard.(2)Investigation of duration of diabetes and glycemic control status:the cases with the mean disease course<2 years were most in the total 323 patients (187/323),and the mean HbA1c value of the patients with the mean disease course<3 months reached maximum(9.48 mmol/L).(3)Investigation of self monitoring of blood glucose and blood glucose control:only 21.98%respondents(71/323) monitored their blood glucose at home in the past week with the HbA1c standard rate of 29.58%.(4)Investigation of therapeutic regimen and glycemic control:the compliance rate in pure oral medicine group was higher than that in the insulin group. The main reason for starting insulin therapy was due to ineffective-ness of oral medication [59.05%(137/167)],and the control status of HbA1c in patients,who requested injection of insulin,was best with the standard rate of 66.67%. The control status of HbA1c in human insulin group was better. (5)Investigation of con-comitant diseases and blood glucose control:57.89%respondents(187/323) were with concomitant diseases,but the control status of HbA1c in concomitant disease group was in good condition. Conclusion The T2DM patients without targeted HbA1c in the hospital are still in a large proportion(65.94%,213/323). The substandard ratio in insulin group is significantly higher than that in the pure oral medicine group.%目的：了解2型糖尿病患者糖化血红蛋白（HbA1c）控制现状，分析治疗方案及与血糖控制的关系。方法采用横断面研究方法，以调查问卷形式收集患者年龄、病程、降糖药物使用情况等，并留取标本进行HbA1c、血糖、血脂等检测分析。入选2型糖尿病患者323例，平均年龄（55.80±13.36）岁，平均病程（3.41±5.18）年。结果（1）总体血糖控制状况：HbA1c＜7.00%占34.06%（110/323），65.94%（213/323）被调研者HbA1c不达标；（2）糖尿病病程与血糖控制状况：323例患者中糖尿病平均病程小于2年者最多（187例），病程小于3个月者HbA1c均值最高（9.48 mmol/L）；（3）自我血糖监测与血糖控制：仅21.98%（71/323）被调查者在过去1周曾进行自我血糖监测，HbA1c达标率为29.58%；（4）治疗方案与血糖控制：单纯口服药组达标率高于胰岛素组。起始用胰岛素治疗的主要原因为口服药疗效不佳[59.05%（137/167）]，患者自己要求注射胰岛素治疗者HbA1c控制状况最好，达标率为66.67%。使用人胰岛素组HbA1c控制情况较好；（5）伴随疾病与血糖控制：57.89%（187/323）被调研者有伴随疾病，伴随疾病组HbA1c控制状况较好。结论该院2型糖尿病患者仍有较大比例（65.94%，213/323）HbA1c未达标。胰岛素组患者HbA1c未达标比例明显高于单纯口服药物组。