门诊老年2型糖尿病患者降糖药物应用分析  

Application analysis of hypoglycemic drugs in elderly outpatients with type 2 diabetes

作　　者：李友佳[1] 沈秀秀 郑娜[1] 谢姣[1] 王程 张抗怀[1] LI Youjia;SHEN Xiuxiu;ZHENG Na;XIE Jiao;WANG Cheng;ZHANG Kanghuai(Department of Pharmacy,the Second Affiliated Hospital of Xi′an Jiaotong University,Xi′an 710004,China;People′s Hospital of Dingbian County,Dingbian 718600,China;School of Pharmacy,Xi′an Jiaotong University,Xi′an 710061,China)

机构地区：[1]西安交通大学第二附属医院药学部,西安710004 [2]定边县人民医院,定边718600 [3]西安交通大学药学院,西安710061

出　　处：《西北药学杂志》2020年第6期945-949,共5页Northwest Pharmaceutical Journal

基　　金：国家自然科学基金青年科学基金项目(编号:81903573);陕西省自然科学基金项目(编号:2019JQ-388)。

摘　　要：目的了解门诊老年2型糖尿病患者降糖药物的用药特点及规律,初步评估降糖药物使用的合理性,为促进降糖药物的临床合理使用提供参考。方法借助医院HIS系统,回顾性分析2019年在医院内分泌门诊就诊的老年2型糖尿病患者的降糖方案。结果共纳入2 058例患者,男∶女=1 055∶1 003,年龄为68.61±7.15岁。单药口服是最常见的降糖给药方式。胰岛素类药物的用药频率最高,其次为二甲双胍、阿卡波糖和二肽基肽酶-4(DPP-4)抑制剂。单药和两药联合降糖是主要的治疗方案。最常用的单药降糖治疗方案是用胰岛素,餐时胰岛素+基础胰岛素是最常用的两药联合降糖治疗方案。阿卡波糖+二甲双胍+胰岛素是常用的三药联合治疗方案。结论二甲双胍使用率偏低,未体现出指南推荐的一线用药地位。部分联合用药会导致低血糖风险高,应密切关注。该院门诊老年2型糖尿病患者降糖药的使用基本合理。Objective To evaluate and promote the medication rationality of hypoglycemic drugs in outpatients by analyzing the medication characteristics and rules of hypoglycemic drugs in elderly outpatients with type 2 diabetes.Methods The application of hypoglycemic agents in elderly patients with type 2 diabetes visiting endocrine clinic in 2019 was retrospectively analyzed with HIS system.Results A total of 2058 patients(male∶female=1055∶1003)aging at 68.61±7.15 years were included.Single-agent oral administration was the most common hypoglycemic therapy.Insulin drugs were used most frequently,followed by metformin,acarbose,and dipeptidyl peptidase-4(DPP-4)inhibitors.Single-agent and double-agent hypoglycemic therapy were the main hypoglycemic medications.Among them,insulin alone was the most commonly used single-agent hypoglycemic treatment.Meal insulin and insulin combined hypoglycemic treatments were the most common double-agent hypoglycemic treatment.Acarbose combined with metformin and insulin was the most common triple-agent hypoglycemic treatment.Conclusion Metformin is used at low frequency despite being a first-line medication recommended by the guidelines.High risk of hypoglycemia of some combination medications should be closely monitored.Overall,the hypoglycemic medications in elderly outpatients with type 2 diabetes is basically reasonable.

关 键 词：降糖药物 门诊 老年患者 2型糖尿病 

分 类 号：R969.3[医药卫生—药理学]