1例成人隐匿性自身免疫糖尿病患者药物治疗管理的药学门诊服务实践  

Practice of Pharmaceutical Outpatient Service for Medication Therapy Management of A Case of Patient with Latent Autoimmune Diabetes in Adults

作　　者：赵群[1] 孙喜梅[1] 李静[1] 司继刚[1] 高婷 ZHAO Qun;SUN Ximei;LI Jing;SI Jigang;GAO Ting(Department of Pharmacy,Central Hospital of Zibo City,Shandong Province,Zibo 255036,China;Binzhou Medical University,Yantai 264003,China)

机构地区：[1]山东省淄博市中心医院药学部,淄博255036 [2]滨州医学院,烟台264003

出　　处：《医药导报》2025年第3期473-478,共6页Herald of Medicine

基　　金：淄博市重点研发计划政策引导类项目(2020ZC010112)。

摘　　要：目的总结1例成人隐匿性自身免疫糖尿病(LADA)门诊患者的药物治疗管理(MTM),为类似疾病的治疗提供参考。方法2023年3月27日,医师推荐1例61岁男性LADA患者到药学门诊。药师通过药学问诊、用药评估、药物重整、用药宣教和药学随访为患者提供MTM服务,每周复诊或药学随访1次,并为患者建立MTM档案。结果3个多月为患者提供MTM服务15次,其中药学门诊接诊8次,药学随访7次。2023年7月10日,患者动脉粥样硬化性心血管疾病(ASCVD)监测指标空腹血糖、糖化血红蛋白、血压、心率、低密度脂蛋白胆固醇和同型半胱氨酸分别由MTM服务前的7.17 mmol·L^(-1)、6.8%、140~150/90~100 mmHg、80~90次·min^(-1)、2.15 mmol·L^(-1)、16.30μmol·L^(-1)下降至MTM服务后的6.06 mmol·L^(-1)、6.1%、120~130/70~80 mmHg、60~70次·min^(-1)、1.63 mmol·L^(-1)、8.67μmol·L^(-1),ASCVD监测指标得到有效控制。32周后复查,患者空腹C-肽水平保持稳定,胰岛功能未进一步下降,心脏超声显示心脏功能改善。结论通过为LADA患者提供MTM服务,重整药物治疗方案,其血糖、血压、血脂、心率和同型半胱氨酸等ASCVD监测指标均控制达标,有效保护了患者胰岛β细胞和靶器官功能,显著提升了患者健康管理水平。Objective To summarize a case of latent autoimmune diabetes in adults(LADA)who received medication therapy management(MTM)of pharmaceutical outpatient service,and to provide reference for the treatment of similar diseases.Methods The physician recommended a 61-year-old male patient with LADA to the pharmacy clinic on March 27,2023.The pharmacists provided MTM services for the patient through pharmacy inquiry,medication evaluation,medication reconciliation,medication education,and pharmacy follow-up,return visit or pharmacy follow-up for the patient once a week,and established the patient MTM archives.Results Through fifteen MTM services for over three months,including eight visits to the pharmaceutical outpatient clinic and follow-up seven times.On July 10,2023,the atherosclerotic cardiovascular disease(ASCVD)monitoring indicators,such as fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),blood pressure,heart rate,low density lipoprotein cholesterol(LDL-C),and homocysteine(HCY),reduced from 7.17 mmol·L^(-1),6.8%,140-150/90-100 mmHg,80-90 times·min^(-1),2.15 mmol·L^(-1),16.30μmol·L^(-1)to 6.06 mmol·L^(-1),6.1%,120-130/70-80 mmHg,60-70 times·min^(-1),1.63 mmol·L^(-1),8.67μmol·L^(-1)after MTM services.The ASCVD monitoring indicators were effectively controlled.After thirty-two weeks,the re-examination of the patient's fasting C-P level remained stable,there was no significant decline in pancreas islet function,and cardiac ultrasound showed that cardiac function had a certain improvement.Conclusion By providing MTM services and reconciliation the medication regimen for the patient with LADA,the ASCVD monitoring indicators such as blood glucose,blood pressure,blood lipids,heart rate,and homocysteine were controlled to meet the standards,effectively protecting the pancreaticβ-cell and target organs functions of the patient,and significantly improving his health management level.

关 键 词：药学门诊 成人隐匿性自身免疫糖尿病 药物治疗管理 

分 类 号：R95[医药卫生—药学] R969