“一站式”综合管理多重代谢紊乱患者代谢指标治疗效果的变化分析  

Effect of "one-stop" outpatient management on the control rate of multiple metabolic disorders patients

作　　者：杨林承[1] 张瑞涛[1] 徐玲[1] 王雅亭 徐东晓[1] 朱丹[1] 唐熠达 Yang Lincheng;Zhang Ruitao;Xu Ling;Wang Yating;Xu Dongxiao;Zhu Dan;Tang Yida(Department of Cardiology and Institute of Vascular Medicine,Peking University Third Hospital,National Health Commission Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides,Key Laboratory of Molecular Cardiovascular Science,Ministry of Education,Beijing Key Laboratory of Cardiovascular Receptors Research,Beijing 100191,China)

机构地区：[1]北京大学第三医院心内科国家卫生健康委心血管分子生物学与调节肽重点实验室分子心血管学教育部重点实验室心血管受体研究北京市重点实验室,北京100191

出　　处：《中华医学杂志》2022年第46期3698-3703,共6页National Medical Journal of China

基　　金：北京大学第三医院人才引进科研启动经费(BYSYZD2020001)。

摘　　要：目的探究门诊“一站式”综合管理前后多重代谢紊乱患者药物治疗方案及治疗达标率的变化。方法选取2020年11月至2022年4月于北京大学第三医院心内科“一站式”综合管理门诊建立档案并规律就诊的合并多重代谢紊乱患者作为研究对象,共有332例。通过门诊电子病历系统采集患者的一般信息、既往史、家族史、药物治疗方案、血压及身高、体重、腰围、臀围等,同时对患者进行“一站式”综合管理随访。分析患者的基线临床特征,并对比门诊“一站式”综合管理前后患者代谢指标变化及不同代谢紊乱患者的治疗方案及达标情况。结果332例患者首次就诊至末次就诊的时间间隔为44(26,60)周,年龄为(57.2±13.2)岁,其中男219例(66.0%)。经心血管门诊“一站式”综合管理后,患者空腹血糖(FBG)由6.6(5.6,7.9)mmol/L降至6.3(5.6,6.9)mmol/L,糖化血红蛋白A1c(HbA1c)由(7.2±1.5)%降至(6.6±0.8)%,低密度脂蛋白胆固醇(LDL-C)由2.70(1.97,3.55)mmol/L降至2.04(1.66,2.63)mmol/L,血尿酸(UA)由(383.7±107.1)μmol/L降至(341.2±90.6)μmol/L(均P<0.05)。高血压[19.8%(50例)提升至28.2%(71例)]、糖尿病[45.2%(85例)提升至66.5%(125例)]、高脂血症[54.9%(151例)提升至87.6%(241例)]、高尿酸血症[16.7%(16例)提升至49.0%(47例)]的治疗达标率均提升(均P<0.05)。结论心血管门诊“一站式”综合管理可改善患者代谢紊乱情况,提高代谢紊乱性疾病治疗的达标率。Objective To explore the effect of"one-stop"outpatient management on the therapeutic schedule and control rate of patients with metabolic disorders.Methods A total of 332 patients who met the inclusion criteria were enrolled and treated regularly in the"one-stop"outpatient department of the Department of Cardiology of the Third Hospital of Peking University from November 1,2020 to April 30,2022.The general information,personal history,family history,drug treatment plan,blood pressure,height,weight,waist circumference,and hip circumference of patients were collected through the outpatient electronic medical record system,and patients were followed up through conducting"one-stop"comprehensive management.The baseline clinical characteristics were analyzed,and the changes of metabolic indexes,treatment conditions and control rate of patients with different metabolic disorders before and after the"one-stop"outpatient management were compared.Results The time interval between the first visit and the last visit was 44(26,60)weeks in 332 patients,whose age was(57.2±13.2)years,including 219 males(66.0%).After the"one-stop"outpatient management,fasting blood glucose(FBG)[6.6(5.6,7.9)mmol/L vs 6.3(5.6,6.9)mmol/L],glycosylated hemoglobin A1c(HbA1c)[(7.2±1.5)%vs(6.6±0.8)%],low density lipoprotein cholesterol(LDL-C)[2.70(1.97,3.55)mmol/L vs 2.04(1.66,2.63)mmol/L]and blood uric acid(UA)[(383.7±107.1)μmol/L vs(341.2±90.6)μmol/L]all decreased significantly(all P values<0.05).The control rates of hypertension(19.8%vs 28.2%),diabetes(45.2%vs 66.5%),hyperlipidemia(54.9%vs 87.6%)and hyperuricemia(16.7%vs 49.0%)were significantly improved after the"one-stop"outpatient management(all P values<0.05).Conclusion The"one-stop"outpatient management of cardiovascular department can significantly improve the metabolic condition and the control rate of patients with multiple metabolic disorders.

关 键 词：心血管疾病 代谢疾病 治疗达标 

分 类 号：R589[医药卫生—内分泌]