综合性医院非内分泌专科住院糖尿病患者降糖药物的应用情况调查  

A survey on the hypoglycemic agents applied to diabetic inpatients in non-endocrinological wards of a comprehensive general hospital

作　　者：谷秀莲[1] 窦京涛[1] 谷伟军[1] 杨国庆[1] 杜锦[1] 陈康[1] 杨丽娟[1] 臧丽[1] 王先令[1] 金楠[1] 吕朝晖[1] 巴建明[1] 母义明[1] 陆菊明[1] 李江源[1] 潘长玉[1] 

机构地区：[1]解放军总医院内分泌科、全军内分泌代谢重点实验室,北京100853

出　　处：《中华内分泌代谢杂志》2017年第7期541-547,共7页Chinese Journal of Endocrinology and Metabolism

摘　　要：目的 总结解放军总医院非内分泌科住院糖尿病患者降糖药物的应用情况,并分析其随年份的变化趋势.方法 以2000年1月至2014年5月于解放军总医院非内分泌科住院治疗的糖尿病患者为研究对象,采用分层随机抽样的方法,共抽取内科科室（内分泌科除外）和外科科室住院糖尿病患者共 10 041 例,利用病案检索系统,对所有患者的住院资料进行回顾性分析.结果 非内分泌科住院患者中,应用胰岛素类、双胍类、α-糖苷酶抑制剂和磺脲类药物降糖的比例较高,分别为50.2%、36.9%、21.3%和 18.9%.常用口服降糖药物中应用比例较高的分别是二甲双胍（36.9%）和阿卡波糖（21.0%）,常用胰岛素制剂中应用比例较高的是精蛋白生物合成人胰岛素（预混30R,14.0%）和甘精胰岛素（8.7%）.不同科室用药情况不一,内科患者应用比例较高的药物分别为双胍类、磺脲类、α-糖苷酶抑制剂和胰岛素类药物,而外科患者降糖药物以胰岛素类为主.随着年份的增加,磺脲类和双胍类药物的应用比例下降,而胰岛素类、格列奈类、α-糖苷酶抑制剂和噻唑烷二酮类药物的应用比例逐渐增加.结论 住院患者多数使用口服药降糖治疗,降糖药物种类以双胍类、α-糖苷酶抑制剂和胰岛素类为主,而胰岛素以精蛋白生物合成人胰岛素注射液（预混30R）和甘精胰岛素应用最多.Objective To summarize the current status and trend of hypoglycemic agents of diabetic inpatients in different departments of Chinese PLA General Hospital.Methods The clinical data of diabetic patients admitted to Chinese PLA General Hospital from January 2000 to May 2014 were collected（those hospitalized in the department of endocrinology were excluded）.A total of 10 041 patients were selected by stratified random sampling.The type of hypoglycemic agents in different departments and the variation on anti-hyperglycemic drugs with time were retrospectively analyzed.Results Of all the patients in non-endocrinological wards, 50.2% were treated with insulin, 36.9% with metformin, 21.3% with α-glycosidase inhibitor, and 18.9% with sulfonylureas.Metformin, α-glucosidase inhibitors, pre-mixed 30R, and insulin glargine were more commonly used than other anti-hyperglycemic agents, accounting for 36.9%, 21.0%, 14.0%, 8.7%, respectively.Metformin, sulfonylureas, α-glucosidase inhibitor, and different types of insulin were more widely applied in internal medicine while insulin therapy was more frequently used in surgical department.During the past 15 years, the proportions of insulin, glinides, α-glucosidase inhibitor, and thiazolidinediones application were gradually increased, while the proportions of sulfonylureas and metformin treatment were on the decline trend.Conclusion Most of the inpatients were treated with oral antidiabetic drugs.Metformin, α-glucosidase inhibitor, pre-mixed 30R, and insulin glargine were the most frequently prescribed agents for the inpatients.

关 键 词：住院 糖尿病 口服降糖药 胰岛素 

分 类 号：R587.1[医药卫生—内分泌]