分级诊疗模式下2型糖尿病患者起始基础胰岛素治疗的对比分析  

Contrastive analysis of initial basic insulin therapy in diabetic patients under the hierarchical diagnosis and treatment mode

作　　者：王娟 刘丽 吕梅 刘翔[2] 刘萍[2] WANG Juan;LIU Li;LV Mei;LIU Xiang;LIU Ping(Endocrinology Department,The Third People’s Hospital of Yinchuan,Yinchuan 750001,China;Endocrinology Department,The General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏银川市第三人民医院内分泌科,宁夏银川750001 [2]宁夏医科大学总医院内分泌科,宁夏银川750004

出　　处：《宁夏医学杂志》2021年第6期539-541,共3页Ningxia Medical Journal

基　　金：宁夏医科大学科学研究基金资助项目(XM2018073)。

摘　　要：目的比较在分级诊疗模式下的二级医院、三级医院2型糖尿病(T2DM)患者起始基础胰岛素治疗方面存在的差异。方法选取血糖控制不佳的T2DM患者389例,分为三级医院组203例,二级医院组186例,给予口服降糖药联合基础甘精胰岛素或餐时速效胰岛素联合基础甘精胰岛素降糖治疗,随访3个月。收集治疗前后空腹血糖(FPG)、糖化血红蛋白(HbA_(1C))及相关药物剂量等指标,并对结果进行对比分析。结果二级医院组治疗前后的FPG、HbA_(1C)均高于三级医院组(P<0.05);二级医院组出院时HbA_(1C)达标率低于三级医院组(P<0.05);2组患者间FPG达标率、胰岛素日剂量差异无统计学意义(P>0.05)。结论在T2DM患者起始基础胰岛素血糖管理中,二级医院与三级医院比较存在一定的差异,故基层医院糖尿病专科化管理非常重要,应进一步加强基层医院的内分泌专科培训。Objective To compare the differences in the initial basic insulin therapy of diabetic patients between the gradeⅡand the grade Ⅲ hospitals under the hierarchical diagnosis and treatment mode.Methods 389 patients with poor blood glucose control were divided into the grade Ⅲ hospital group(203 cases)and the grade Ⅱ hospital group(186 case).They were treated with oral hypoglycemic medicines combined with basic insulin or dinner short-acting insulin and basic insulin hypoglycemic therapy for 3 months.The indexes of fasting blood glucose(FPG),glycaemic hemoglobin(HbA1c)at admission,the type and dosage of oral hypoglycemic medicines were observed and compared.Results FPG and HbA1c in the grade Ⅱ hospital group were higher than that of the grade Ⅲ hospital group(P<0.05).The HbA1c standard rate of the gradeⅡhospital group was lower than that of the grade Ⅲ hospital group(P<0.05).There was no significant difference between the two groups in FPG control rates and the daily dose of insulin.Conclusion In the initial basic insulin glucose management of T2DM patients,there are some differences between the grade Ⅱ hospital and gradeⅢ hospital,Therefore,the specialized management of diabetes in the primary hospitals is very important,and the endocrine training in the primary hospitals should be further strengthened.

关 键 词：分级诊疗 2型糖尿病 基础胰岛素 

分 类 号：R587.1[医药卫生—内分泌]