驻科药师对糖尿病患者动脉粥样硬化性心血管疾病风险管理的效果  

Effect of resident pharmacists on ASCVD risk management in diabetic patients

作　　者：柴东燕[1,5] 王炳坤 段红艳 徐成阳[5] 武园园 索小鸽 刘廉青 梁新亮 CHAI Dongyan;WANG Bingkun;DUAN Hongyan;XU Chengyang;WU Yuanyuan;SUO Xiaoge;LIU Lianqing;LIANG Xinliang(Department of Pharmacy,Henan Provincial People's Hospital,Henan Zhengzhou 450003,China;Network Information Center,Henan Provincial People's Hospital,Henan Zhengzhou 450003,China;Department of General Practice,Henan Provincial People's Hospital,Henan Zhengzhou 450003,China;Department of Public Service Department&Henan Province Engineering Research Center of Technology Research and Application of Telemedicine Service,Henan Provincial People's Hospital,Henan Zhengzhou 450003,China;International Medical Center of Henan Province,Henan Zhengzhou 450003,China;Department of Clinical Pharmacy,Jiaozuo People's Hospital,Henan Jiaozuo 454000,China;Department of Pharmacy,Xin'an County Second People's Hospital,Henan Luoyang 471800,China;Department of Pharmacy,Xin'an County People's Hospital,Henan Luoyang 471800,China)

机构地区：[1]河南省人民医院药学部,河南郑州450003 [2]河南省人民医院网络信息中心,河南郑州450003 [3]河南省人民医院全科医学科,河南郑州450003 [4]河南省人民医院公事业发展部/河南省远程医疗诊治技术研发与应用工程研究中心,河南郑州450003 [5]河南省国际医疗中心,河南郑州450003 [6]焦作市人民医院临床药学室,河南焦作454000 [7]新安县第二人民医院药剂科,河南洛阳471800 [8]新安县人民医院药学部,河南洛阳471800

出　　处：《中国医院药学杂志》2025年第4期467-471,共5页Chinese Journal of Hospital Pharmacy

基　　金：河南省医药科技攻关计划软科药项目(编号:RKX202402004);河南科技智库调研课题(编号:HNKJZK-2022-58B)。

摘　　要：目的:探讨驻科药师参与多学科团队(multidisciplinary team,MDT)照护对糖尿病患者10年动脉粥样硬化性心血管疾病(atherosclerotic cardiovascular disease,ASCVD)发病风险评分的影响。方法:回顾性分析2020年1月至2023年12月住院次数大于等于2次的非ASCVD糖尿病患者,共纳入460例患者,其中186例接受驻科药师参与多学科团队照护(MDT组),274例接受常规照护(对照组)。采用倾向性评分匹配分析平衡2组偏倚,成功匹配109对,对比2组患者ASCVD风险评分变化、低密度脂蛋白达标率、糖化血红蛋白、ASCVD高危人群他汀服用率、戒烟率的影响。结果:MDT组和对照组ASCVD评分变化有显著性差异[0.00 (-4.60,3.40) vs.1.40 (-1.20,4.50),P=0.022];MDT组低密度脂蛋白达标率78.9%,明显高于对照组21.1%(P=0.002);糖化血红蛋白明显低于对照组(P<0.01);高危人群中服用他汀率62.5%,明显高于对照组12.9%(P<0.01);戒烟率2组无明显差异。结论:驻科药师参与MDT团队可以延缓糖尿病患者ASCVD发病风险评分的升高。OBJECTIVE To explore the impact of multidisciplinary team(MDT)care involving resident pharmacists on the 10-year risk score of atherosclerotic cardiovascular disease(ASCVD)in patients with diabetes mellitus.METHODS Retrospective analysis of 460 non-ASCVD patients with diabetes mellitus admitted twice or more from January 2020 to December 2023 was conducted,including 186 patients receiving MDT care(MDT group)participated by resident pharmacists,and 274 patients receiving routine care(control group).Propensity score matching analysis was used to balance two groups of bias,and 109 pairs were successfully matched.The changes in ASCVD risk scores,the proportion of patients reaching LDL-C goal,hemoglobin A1c(HbA_(1)c),the rate of taking statins among high-risk populations and smoking cessation rate were compared to evaluate the effectiveness.RESULTS There was a significant difference in ASCVD score change between the MDT and control groups[0.00(-4.60,3.40)vs.1.40(-1.20,4.50),P=0.022].The proportion of patients reaching LDL-C goal in the MDT group was significantly higher than that of the control group(78.9%vs.21.1%,P=0.002).HbA_(1)C was significantly lower than that in the control group(P<0.01).The rate of taking statins among high-risk groups was significantly higher than the control group(62.5%us.12.9%,P<0.01).There was no significant difference in smoking cessation rates.CONCLUSION The MDT involving resident pharmacists can delay the increase of the risk score of ASCVD in diabetes.

关 键 词：多学科团队 倾向性评分匹配 驻科药师 动脉粥样硬化性心血管疾病 风险评估 

分 类 号：R955[医药卫生—药学]