摘要
目的 评价昆明市两个社区卫生服务中心糖尿病慢病管理的2型糖尿病患者血糖、血压及血脂控制情况,为促进基层糖尿病慢病管理工作提供依据.方法 选择2021年11月至2022年2月昆明市官渡区两个社区卫生服务中心签约的178例18～85岁2型糖尿病慢病管理患者,由专业人员采集患者基本资料,测量血压,抽取清晨空腹静脉血标本,进行空腹血糖(fasting blood glucose,FBG)、糖化血红蛋白(glycosylated hemoglobin,HbA1c)、血脂等指标的检测,收集相关数据,根据《2020年中国2型糖尿病防治指南》标准,用描述性分析、χ2检验等统计分析方法,评价社区2型糖尿病慢病管理患者血糖、血压及血脂的控制达标情况.结果 178例2型糖尿病患者HbA1c(7.72±1.86)%,达标率为39.9%,FBG(8.60±3.39)mmol/L,达标率为37.1%;低密度脂蛋白胆固醇(low density lipoprotein-cho-lesterol,LDL-C)(3.25±1.18)mmol/L,达标率11.8%,总胆固醇(total cholesterol,TC)(5.33±1.21)mmol/L,达标率23.0%,高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)(1.38±0.44)mmol/L,达标率64.0%,甘油三酯(triglyceride,TG)(2.48±2.03)mmol/L,达标率39.9%;收缩压(systolic blood pressure,SBP)(138±16)mmHg,舒张压(diastolic blood pressure,DBP)(81±11)mmHg,达标率36.0%.除LDL-C外,其余指标达标率均不及40%.结论 昆明市两个社区卫生服务中心2型糖尿病慢病管理患者血糖、血压及血脂控制达标率较低,基层糖尿病慢病管理现状不容乐观,需对其原因进行深入调查及分析,积极探索建立社区糖尿病慢病管理新模式.
Abstract
Objective To evaluate the control of blood glucose,blood pressure and lipids in type 2 diabetes mellitus patients undergoing diabetes mellitus chronic disease management in two community health service centers in Kunming,and to provide a basis for promoting diabetes mellitus chronic disease management at the grassroots level.Methods One hundred and seventy-eight patients aged 18-85 years with type 2 diabe-tes mellitus under chronic disease management contracted at two community health service centers in Guandu District,Kunming were selected.Basic patient information was collected by professionals,blood pressure was measured,early morning fasting venous blood specimens were drawn and fasting blood glucose(FBG),glycosylated haemoglobin(HbA1c)and lipids were tested,relevant data were collected and according to the criteria of the 2020 Chinese guidelines for the prevention and treatment of type 2 diabetes mellitus.Statisti-cal analysis methods such as descriptive analysis andχ2 test were used to evaluate the achievement of control of blood glucose,blood pressure and lipids in patients with type 2 diabetes mellitus under chronic disease management in the community.Results HbA1c of 178 patients with type 2 diabetes mellitus was(7.72±1.86)%,with an attainment rate of 39.9%,FBG was(8.60±3.39)mmol/L,with an attainment rate of 37.1%,low density lipoprotein-cholesterol(LDL-C)was(3.25±1.18)mmol/L,with an attainment rate of 11.8%,and total cholesterol(TC)was(5.33±1.21)mmol/L,with an attainment rate of 23.0%,high density lipoprotein-cholesterol(HDL-C)was(1.38±0.44)mmol/L,with an attainment rate of 64.0%,triglyceride(TG)was(2.48±2.03)mmol/L,the standard rate of 39.9%,systolic blood pressure(SBP)was(138±16)mmHg,diastolic blood pressure(DBP)was(81±11)mmHg,the compliance rate of 36.0%.Except for HDL,the compliance rate of the other indicators was less than 40%.Conclusions The achievement rates of glycemic,blood pressure and lipid control in patients with type 2 diabetes mellitus in two community health centers in Kunming are low.The current situation of diabetes mellitus management at the grassroots level is not optimistic,and the reasons behind it need to be investigated and analyzed in depth to explore the establishment of a new model of diabetes mellitus management in the community.
基金项目
云南省科技厅科技计划项目(202001AY070001-197)
维普
万方数据