北京新街口社区2型糖尿病患者强化干预三年效果分析

遵循患者自愿的原则,对2008年在社区就诊的2型糖尿病患者316例,在药物治疗基础上,结合健康教育和生活方式等强化干预方式,进行了为期3年的干预观察.定期监测和记录患者的BMI、血压、空腹血糖、餐后2h血糖、HbA1c、血脂、肝肾功能等指标.干预前后患者各项指标分别为：BMI（25.2±3.5）与（25.0±3.3） kg/m2,收缩压（129.1±11.8）与（126.2 ±7.9） mm Hg（1 mm Hg=0.133 kPa）,空腹血糖（7.80±2.81）与（7.25±1.96） mmol/L,餐后2h血糖（11.04±4.60）与（9.83±3.60） mmol/L,HbA1c（7.39±1.61）与（7.17±1.65）％,TC（5.08±1.21）与（4.74±1.35） mmol/L,LDL-C（3.09±0.87）与（2.85±0.83） mmol/L,HDL-C（1.27±0.33）与（1.41±0.32）mmol/L,血肌酐65与72 μmol/L、血尿酸300与317μmol/L.干预后患者血压达标率由干预前72.5％提高至88.0％,LDL-C由27.2％提高至38.6％,HDL-C由54.9％提高至66.9％,前后差异均有统计学意义（P＜0.05）.干预前患者的联合达标率11.4％（36例）,干预后17.7％（56例）,前后差异有统计学意义（P =0.024）.

Effect evaluation analysis of three years intensive intervention for patients with type 2 diabetes at Xinjiekou Community Center in Beijing

Following the wishes of volunteer patients,316 cases of type 2 diabetics of our community center in 2008 carried out a three-year intervention from 2008 to 2011 on the basis of rational drug therapy plus the interventions of health education,regular review and lifestyle strengthening.And regular monitoring and recording were performed on the parameters of body mass index （BMI）,blood pressure,blood lipids,fasting glucose,2 h postprandial blood glucose,glycosylated hemoglobin （HbA1c） and liver ＆ kidney function.After intervention,some indicators changed：BMI （25.2 ±3.5） vs.（25.0 ±3.3） kg/m2,systolic blood pressure （129.1 ± 11.8） vs.（126.2 ±7.9） mm Hg（1 mm Hg=0.133 kPa）,fasting glucose （7.80 ±2.81） vs.（7.25 ± 1.96） mmol/L,2 h postprandial blood glucose （11.04 ±4.60） vs.（9.83 ±3.60） mmol/L,HbA1c （7.39 ± 1.61） vs.（7.17 ± 1.65）％,total cholesterol （5.08 ±1.21） vs.（4.74 ± 1.35） mmol/L,low density lipoprotein cholesterol（LDL） （3.09 ± 0.87） vs.（2.85 ±0.83） mmol/L,high density lipoprotein cholesterol （HDL） （1.27 ± 0.33） vs.（1.41 ± 0.32） mmol/L,serum creatinine 65 vs.72 μmol/L,uric acid 300 vs.317 μmol/L.And the differences were statistically significant （P ＜ 0.05）.After intervention,blood pressure compliance rate increased from 72.5％ to 88.0％,LDL-C compliance rate improved from 27.2％ to 38.6％,HDL-C compliance rate of 54.9％ increased to 66.9％.And the differences were statistically significant （P ＜ 0.05）.The pre-intervention combined compliance rate of 11.4％ （n =36） rose to 17.7％ （n =56）.And there was significant difference （P =0.024）.