2型糖尿病患者卒中一级预防的现况调查  

Survey of the Current Status of Primary Stroke Prevention in Patients with Type Ⅱ Diabetes

作　　者：李征[1] 郭莹[1] 马于堃[1] 刘洪宇[1] 李小荣[1] 钟历勇[1] 

机构地区：[1]首都医科大学附属北京天坛医院内分泌科,北京市100050

出　　处：《中国卒中杂志》2007年第7期565-568,共4页Chinese Journal of Stroke

摘　　要：目的了解2型糖尿病患者住院前及住院期间卒中各危险因素的干预状况,发现临床实践与证据之间的差距,提高临床医生对卒中一级预防的认识,指导今后的临床治疗。方法本调查为横断面调查研究,回顾性调查167例2型糖尿病患者住院前及住院期间对卒中主要危险因素的干预情况。结果被调查的患者中,入院前有46.7%的患者有高血压;36.0%的患者有吸烟史;19.8%的患者存在冠状动脉粥样硬化性心脏病,0.6%的患者有心房颤动;23.4%的患者有脂代谢异常。出院前有56.9%的患者被诊断高血压;81.4%的患者存在脂代谢异常。入院前与出院前对血压的药物干预率差异无统计学意义(分别为75.6%及80.0%,P>0.05);入院前后的降脂治疗(分别为25.6%及69.1%,P<0.01)及降糖治疗(分别为82.0%及97.6%,P<0.01)的差异均有统计学意义。结论2型糖尿病患者院前对危险因素干预的达标率较低,应加强2型糖尿病患者及临床医生对卒中一级预防的认识,提高卒中卒中相关危险因素的干预率。Objective To investigate the current status of the risk factor management in patients with type Ⅱ diabetes prior to and during their hospitalization.To look for the difference between the evidence-based guidelines and its clinical practice,and to improve the knowledge levels of clinicians on the importance of primary stroke prevention.Methods This is a retrospective cross-sectional study.One hundred sixty seven patients with type Ⅱ diabetes were surveyed on their status of stroke risk factor management prior and during the hospitalization.Results Of these 167 patients,46.7% had hypertension,36.0% were smokers,0.6% had atrial fibrillation,19.8% had coronary heart disease,and 23.4% had hyperlipidemia prior to their hospitalization.During the hospitalization,56.9% were diagnosed with hypertension and 81.4% had hyperlipidemia.About 75.6% diabetic patients were treated for hypertension prior to being hospitalized,and 80.0% in-hospital patients were treated for hypertension(P>0.05).For hyperlipidemia,25.6% patients were treated prior to hospitalization and 69.1% in-hospital patients were treated(P<0.01).For glucose-lowing therapy,82.0% of prehospital patients were treated and 97.6% in-hospital patients were treated(P<0.01).Conclusion The rates of treatment of stroke risk factors in type Ⅱ diabetic patients were low before they were hospitalized.Therefore,it is important to improve physicians' behavior on the recognition and management of stroke risk factors in these patients.

关 键 词：糖尿病 2型 卒中 一级预防 

分 类 号：R587.1[医药卫生—内分泌] R743.3[医药卫生—内科学]