标准化代谢性疾病管理模式在早期糖尿病肾病患者中的应用价值  

Application Value of Standardized Metabolic Disease Management Model in Patients with Early Diabetic Kidney Disease

作　　者：田勇 董其娟 李丽[1] 樊倩影 杨敬随 尤晓珂 胡涓 TIAN Yong;DONG Qijuan;LI Li;FAN Qianying;YANG Jingsui;YOU Xiaoke;HU Juan(Department of Endocrinology and Metabolism,People’s Hospital of Henan University of Chinese Medicine/People’s Hospital of Zhengzhou,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学人民医院/郑州人民医院内分泌代谢科,河南郑州450003

出　　处：《河南医学研究》2021年第13期2317-2320,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划联合共建项目(2018020817);郑州市科技惠民项目(郑科〔2018〕50号)。

摘　　要：目的探讨标准化代谢性疾病管理模式在早期糖尿病肾病(DKD)患者中的应用价值。方法选取2018年1月至2019年1月在郑州人民医院内分泌代谢科住院的120例2型早期DKD患者为研究对象,采用随机数表法将其分为对照组和观察组,各60例。对照组接受常规评估治疗及出院常规健康指导,观察组在对照组基础上加入标准化代谢性疾病管理中心(MMC)接受标准化的综合管理。观察出院1 a后两组患者空腹血糖(FPG)、餐后2小时血糖(2 h PG)、糖化血红蛋白(HbAlc)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)及尿白蛋白肌酐比值(UACR)。结果失访11例,最终纳入对照组56例,观察组53例。干预1 a后,两组FBG、2 h PG、HbA1c、TC、LDL-C、UACR水平均较干预前下降,且观察组FBG、2 h PG、HbA1c、TC、LDL-C、UACR水平均较对照组低(P<0.05)。结论标准化代谢性疾病管理模式通过院内外全过程的标准化综合管理,可提升早期DKD患者血糖、血脂达标率,减少微量蛋白尿排泄,延缓DKD的进展。Objective To explore the application value of standardized metabolic disease management model in patients with early diabetic kidney disease(DKD).Methods A total of 120 patients with type 2 early DKD who were hospitalized in the Department of Endocrinology and Metabolism of People’s Hospital of Zhengzhou from January 2018 to January 2019 were selected as the research subjects.They were divided into control group(60 cases)and observation group(60 cases)according to the random number table method.Control group received routine assessment and treatment and discharge routine health guidance.Observation group joined Metabolic Management Center(MMC)to receive standardized comprehensive management on the basis of control group.The fasting blood glucose(FPG),2 hour-postprandial blood glucose(2 h PG),glycosylated hemoglobin(HbAlc),total cholesterol(TC),low density lipoprotein-cholesterol(LDL-C)and urinary albumin creatinine ratio(UACR)were observed 1 year after discharge.Results A total of 11 cases were lost to follow-up,and 56 cases were included in control group,and 53 cases were included in observation group.One year after intervention,the levels of FBG,2 h PG,HbA1c,TC,LDL-C,UACR in the two groups decreased compared with those before intervention,and the levels of FBG,2 h PG,HbA1c,TC,LDL-C,UACR in observation group were all lower than those in control group(P<0.05).Conclusion The standardized metabolic disease management model can improve the compliance rates of blood glucose and blood lipid of patients with early DKD and reduce the excretion of microalbuminuria and delay the progression of DKD through standardized comprehensive management in the whole process inside and outside the hospital.

关 键 词：早期糖尿病肾病 标准化代谢性疾病管理模式 糖化血红蛋白 尿白蛋白肌酐比值 

分 类 号：R587.1[医药卫生—内分泌]