北京市社区2型糖尿病患者国家基本降糖药物治疗更改原因的调查研究  

A survey on the reasons for the change of the antidiabetic drugs in the national essential medicine list among patients with type 2 diabetes in Beijing communities

作　　者：陈敏[1,2] 窦京涛[1] 庄晓明[3] 东黎光[4] 阮丹杰 丁静[6] 张永顺 田勇[5] 赵继红[4] 巫继东[6] 付亚军[6] 黄兴华 王淑玉 

机构地区：[1]解放军总医院内分泌科,北京100853 [2]首都医科大学附属复兴医院 [3]首都医科大学附属复兴医院内分泌科 [4]北京大学附属首钢医院苹果园社区卫生服务中心 [5]北京市怀柔区第一医院怀柔糖尿病防治中心 [6]首都医科大学附属复兴医院月坛社区卫生服务中心 [7]北京市丰台区花乡社区卫生服务中心 [8]北京市高血压联盟研究所

出　　处：《中国糖尿病杂志》2016年第9期778-781,共4页Chinese Journal of Diabetes

基　　金：首都医学发展科研基金(2009-1021)

摘　　要：目的了解北京市不同区域社区T2DM患者在血糖达标治疗过程中，《国家基本药物目录》中降糖药物（下称“国家基本降糖药物”）使用现状及更改原因，为推进社区T2DM患者管理的进程提供依据。方法纳入北京市4个社区卫生服务中心的T2DM患者900例。以HbA1c〈7％为目标，随访1年后分析其对国家基本降糖药物使用状况及更改的原因。结果随访1年后，7种国家基本降糖药物更改原因构成比比较，差异无统计学意义（x^2=25．176，P=0．396），原因主要为血糖控制不佳（63．6％）和个人因素（28．9％）；随访1年后，磺脲类药物被更改的比例最高（51．1％）。结论北京社区T2DM患者更改国家基本降糖药物的主要原因是血糖控制不佳，但也易因个人因素更改，依从性欠佳。磺脲类药物更易被患者更改。Objective To investigate the reasons for the changes of the antidiabetic drugs in national essential medicine list among patients with type 2 diabetes mellitus （T2DM） during the process of blood glucose control in Beijing different communities. Methods 900 patients with T2DM were enrolled from four community health service centers in Beijing. The target of blood glucose control was HbA1 c〈7%. After 1 year follow-up, the data of the reasons for which the patients changed the drugs were performed to analysis. Results The ratio of the patients who changed the antidiabetic drugs in the national essential medicine list was 31.5 % （305/969）. After 1 year follow-up, there was no significant difference among the constitution ratio of the reasons for the changes of 7 antidiabetic drugs in the national essential medicine list （x^2 =25. 176,P= 0. 396）. The main reasons that patients changed the antidiabetic drugs were the poor blood glucose control （63.6 %） and personal factors （28.9 %）. During follow-up, the ratio of the change of sulfonylureas （51.1%） was the biggest, others in turn were biguanides （34.6%）, insulin （34. 2%）, and glycosidase inhibitors （28. 3%）. Conclusion The main reason for the changes of the antidiabetic drugs in the national essential medicine list is the poor control of blood glucose, and then personal factors. The ratio of the change of sulfonylureas is high in T2DM patients in Beijing communities.

关 键 词：糖尿病 2型 国家基本降糖药物 服药依从性 影响因素 

分 类 号：R587.1[医药卫生—内分泌]