石河子社区2型糖尿病患者药物治疗3年随访研究

摘要

目的 研究近3年间石河子社区管理2型糖尿病(T2DM)患者降糖方案构成比和临床结局变化情况.方法 采用整群抽样的方法于2012年11月从石河子的13个社区随机抽取符合标准的T2DM患者300例,进行为期3年的随访观察,收集一般人口学信息、治疗方案、临床结局等资料.结果 与2012年比较,2015年口服药物组患者比例从63.5％降低到51.0％,胰岛素治疗组从30.8％增加到41.8％,其中单药治疗组的比例明显下降(χ2=8.77,P<0.05),胰岛素联合口服药物组的比例明显上升(χ2=-10.27,P<0.01),用药不良反应发生率从16.8％增高至24.5％;2015年血糖指标及达标率较2012年无明显变化,2015年血糖达标率按(1)标准计算为41.2％,较2012年减少了4.0％,按(2)标准计算为52.9％,较2012年增加了1.4％;2015年糖尿病合并症和并发症较2012年明显增加.结论 (1)石河子社区T2DM患者治疗以口服药物治疗为主,胰岛素的使用率有所上升;(2)石河子社区在T2DM患者血糖达标、用药安全性、延缓其并发症及合并症进展等方面有待提高.%Objective To explore the changes of the constituent ratio of hypoglycemic scheme and clinical outcomes of patients with type 2 diabetes mellitus(T2DM)in recent three years in Shihezi. Methods The cluster random sampling methods were used to select 300 patients with T2DM who met the standards in November 2012 from 13 communities in Shihezi. The datasets including general demographic information ,treatment and clinical outcomes were collected by following them up for three years. Results From 2012 to 2015,the proportion of pa-tients with oral drugs decreased from 63.5％ to 51％ while increased from 30.8％ to 41.8％ with insulin treatment. For the patients with insulin treatment ,the rate of patients on single drug therapy declined significantly (χ2 =8.77,P<0.05),while significantly increased on insulin combined with oral drug(χ2=-10.27,P<0.01). The incidence of adverse effects increases from 16.8％ to 24.5％. As compared with 2012,blood sugar levels and con-trol rate had no obvious changes in 2015;namely,according to the standard(1),the control rate of blood glucose in 2015 was 41.2％,decreasing 4.0％as compared with 2012,while according to the standard(2),it increasd by 1.4％ from 2012 to 2015(52.9％). The rate of diabetic complications significantly increased from 2012 to 2015. Conclusions Oral drugs are mainly used in the treatment of T2DM in Shihezi communities,whereas the rate of insulin use elevates. The blood glucose control rate,medication safety,and ability to lower the rate of diabetic com-plications need to be improved in T2DM patients in Shihezi communities.