老年糖尿病住院患者的血糖控制及潜在过度治疗风险的回顾性分析  

Retrospective analysis of potential overtreatment of diabetes mellitus in hospitalized senile patients with tight glycemic control

作　　者：贺飞[1] 于欢[2] 王娜[3] 邓昂[4] HE Fei YU Huan WANG Na DENG Ang(Pharmacy Cancer hospital ＆ Institute, Chinese Academy of Medical Science.Beijing 100021, China a. Department of endocrinology science, b. Department of Pharmacy, China Japan friendship hospital, Beijing 100029, Chin 3. Pharmacy, Fu Wai Hospital, Chinese Academy of Medical Science. Beijing 100037, Chin)

机构地区：[1]中国医学科学院肿瘤医院药剂科,北京100021 [2]中国医学科学院阜外医院药剂科,北京100037 [3]卫生部中日友好医院内分泌科,北京100029 [4]卫生部中日友好医院药学部,北京100029

出　　处：《临床药物治疗杂志》2016年第5期57-60,共4页Clinical Medication Journal

摘　　要：目的:分析老年糖尿病患者住院期间血糖控制水平的合理性,评估住院患者潜在的过度治疗风险情况,从而为合理用药提供依据。方法:对2015年1月至2015年11月入院的235位老年糖尿病患者(≥65岁)进行描述性统计分析。结果:在235例住院老年糖尿病患者中,71.5%的患者健康状况较好,18.3%的患者病史较复杂存在并发症(2组),10.2%的患者至少有一种严重的合并症,生命预期较短(3组)。在235例患者中,17%的患者入院时Hb A1c<7%;在Hb A1c<7%的患者中,37.5%的患者接受了胰岛素或磺脲类药物治疗。出院时,空腹血糖≤7和餐后血糖≤11的患者分别占1、2、3组患者的比例为:2/3、约1/2和不足1/3。结论:按照患者合并疾病的严重程度的由轻到重,出院时患者的血糖达标比例逐渐降低。虽然如此,高风险的降糖药物仍可能导致治疗风险和经济负担的增加。对预期寿命较短、病史复杂的患者更适合通过改变生活方式和使用低风险降糖药物,如二甲双胍等来降糖。Objective： To estimate the potential overtreatment of diabetes mellitus in senile inpatients. Methods： Medical records of 235 patients treated with Glucose-lowering agents were evaluated and a descriptive analysis was carried out. Results： 235 patients were enrolled and divded into three groups （ group 1：71.5% , group 2：18.3% and group 3： 10.2%）. The status of patients in group 1 were relative heath, in group 2 were with complicated disease, and in group 3 were with at least one serious complication.. The proportion of senile inpatients with an HbAlc level less than 7% is 17% and among them, 37.5% patients were treated with insulin or sulfonylureas. The proportion of patients with the fasting blood glucose ≤7 and postprandial blood glucose ≤ 11 in three groups is 2/3 （group 1）, about 1/2（group 2） and 1/3（group 3）, respectivelyConclusion： Our study Suggest that tight glycemic control had always been decided by the health status of older patients and a patient with better health status had received more tight glycemic control. The change of life style and lower risk medication maybe more suitable to older patients with complicated disease.

关 键 词：糖尿病 降糖药物 合理用药 胰岛素 磺脲类药物 

分 类 号：R977.15[医药卫生—药品]