2型糖尿病患者卒中一级预防的现况调查

目的 了解2型糖尿病患者住院前及住院期间卒中各危险因素的干预状况，发现临床实践与证据之间的差距，提高临床医生对卒中一级预防的认识，指导今后的临床治疗。方法 本调查为横断面调查研究，回顾性调查167例2型糖尿病患者住院前及住院期间对卒中主要危险因素的干预情况。结果 被调查的患者中，入院前有46.7%的患者有高血压；36.0％的患者有吸烟史；19.8％的患者存在冠状动脉粥样硬化性心脏病，0.6％的患者有心房颤动；23.4％的患者有脂代谢异常。出院前有56.9％的患者被诊断高血压；81.4％的患者存在脂代谢异常。入院前与出院前对血压的药物干预率差异无统计学意义（分别为75.6%及80.0%，P >0.05）；入院前后的降脂治疗（分别为25.6%及69.1%，P <0.01）及降糖治疗（分别为82.0%及97.6%，P <0.01）的差异均有统计学意义。结论 2型糖尿病患者院前对危险因素干预的达标率较低，应加强2型糖尿病患者及临床医生对卒中一级预防的认识，提高卒中卒中相关危险因素的干预率。

Survey of the Current Status of Primary Stroke Prevention in Patients with Type Ⅱ Diabetes

Objective To investigate the current status of the risk factor management in patients with type IIdiabetes prior to and during their hospitalization. To look for the difference between the evidencebasedguidelines and its clinical practice, and to improve the knowledge levels of clinicians on theimportance of primary stroke prevention.Methods This is a retrospective cross-sectional study. One hundred sixty seven patients with typeII diabetes were surveyed on their status of stroke risk factor management prior and during thehospitalization.Results Of these 167 patients, 46.7% had hypertension, 36.0% were smokers, 0.6% had atrialfibrillation, 19.8% had coronary heart disease, and 23.4% had hyperlipidemia prior to theirhospitalization. During the hospitalization, 56.9% were diagnosed with hypertension and81.4% had hyperlipidemia. About 75.6% diabetic patients were treated for hypertension prior tobeing hospitalized, and 80.0% in-hospital patients were treated for hypertension (P >0.05). Forhyperlipidemia, 25.6% patients were treated prior to hospitalization and 69.1% in-hospital patientswere treated (P <0.01). For glucose-lowing therapy, 82.0% of prehospital patients were treated and97.6% in-hospital patients were treated (P <0.01).Conclusion The rates of treatment of stroke risk factors in type II diabetic patients were lowbefore they were hospitalized. Therefore, it is important to improve physicians’ behavior on therecognition and management of stroke risk factors in these patients.