刘海华 潘涛

[摘要] 目的 探讨2型糖尿病（T2DM）患者社区管理模式下血糖达标的现状，为进一步提高社区管理成效提供依据。方法 连续性纳入2015年6—10月在南京部分社区卫生服务中心门诊就诊的，符合纳入标准的254例 T2DM患者，详细记录患者的一般情况、病史资料、治疗信息、生化检验等临床资料。比较不同学历背景和不同年龄组T2DM患者的治疗效果差异。 结果 大专及以上学历组T2DM患者的血糖控制率和糖化血红蛋白控制达标率，明显高于大专以下学历组患者（空腹血糖P<0.01；餐后2 h血糖P<0.01；糖化血红蛋白P<0.01）。25～45岁组患者空腹血糖达标率、餐后2 h血糖达标率明显升高于>65岁年龄组（P<0.01）；46～65岁组空腹血糖达标率明显高于>65岁年龄组（P<0.05）；46～65岁组餐后2 h血糖达标率明显高于>65岁年龄组（P<0.01）。25～45岁组糖化血红蛋白达标率明显高于>65岁年龄组（P<0.05）。 结论 T2DM患者的血糖控制率和糖化血红蛋白达标率，高学历背景患者及青壮年患者明显高于低学历背景的患者及老年患者，社区医院在T2DM慢病管理方面，应坚强对低学历背景及老年患者的综合监护及健康教育，从而改善T2DM患者的远期预后。[关键词] 2型糖尿病；达标率；社区医院管理；现况研究 [中图分类号] R193

[文献标识码] A

[文章编号] 1672-4062（2016）03（a）-0097-04The Study on the Situation of T2DM Patients in Community ManagementLIU Hai-hua， PAN TaoNanjing University of TCM， Nanjing，Jiangsu Province， 210046 China[Abstract] Objective To investigate the situation of T2DM patients in community management， to evaluate the difference of therapeutic effect in patients with different age groups and educational backgrounds， and to provide evidence for improving therapeutic effect of community management. Methods Two hundreds and fifty-four T2DM patients were collected in this study. All patients were from the Medical clinic of some community health service centers in Nanjing from June 2015 to October 2015. Research content includes general condition， medical history of T2DM， treatment information and biochemical test were recorded. It was analyzed that the difference of therapeutic effect in patients with different age groups and educational backgrounds. Results The Compliance rate of the glycemic and the HbA1c in the patients with College and above group of T2DM w better than the patients with College following groups in FPG（P<0.01）， 2h PBG（P<0.01） and HbA1c（P<0.01）. The Compliance rate of the glycemic and and the HbA1c in the patients who lied in 25～45 age group were better than the patients who lied in > 65 age group in FBG（P<0.01）， 2 h PBG（P<0.01） and the HbA1c（P<0.05）. The Compliance rate of the glycemic in the patients who lied in 46～65 age group were better than the patients who lied in > 65 age group in FPG（P<0.05），2 h PBG（P<0.01）. Conclusion The Compliance rate of the glycemic and the HbA1c in the patients of T2DM with College and above group、25～45 age group and 46～65 age group were better than the patients with College following groups and > 65 age group. So， the doctors in community hospital should enhance the education and guide to patients with T2DM， especially to elderly patients with lower education.[Key words] Type 2 diabetes； Compliance rate；Community hospital management； The status of the investigation糖尿病是一种以高血糖为特征的代谢性疾病，近年来随着城市化、老龄化进程的加快及生活方式的转变，糖尿病的发病率不断攀升，其患病率、致残率和病死率以及对人们生活质量的影响及危害，居慢性非传染性疾病的第3位，2型糖尿病已成为威胁我国居民健康的主要疾病之一，其与冠心病、恶性肿瘤并称为人类健康的三大杀手[1-3]。长期高血糖对组织器官造成严重的损害，引起失明、肾功能衰竭、截肢、冠心病及中风等严重并发症，严重影响患者的身心健康[4]。而糖尿病治疗的复杂性和长期性，均需要患者掌握足够的糖尿病知识[5]。有研究表明，社区管理模式可以较好的控制2型糖尿病患者的血糖水平，其规范化管理与有效防治的作用逐渐受到重视[6]。该研究对 254 例2型糖尿病患者进行随机连续研究，对不同学历背景和不同年龄组患者的血糖达标率进行分析，旨在探讨目前社区管理模式下糖尿病控制的现状，为进一步加强糖尿病的社区和个人管理，进一步提高2型糖尿病患者的达标率提供参考依据，现报道如下。……