某院40~65岁2型糖尿病住院患者ASCVD预防现状研究

目的: 了解北京同仁医院40~65岁2型糖尿病(T2DM)住院患者动脉粥样硬化性心血管疾病(ASCVD)药物预防情况以促进合理用药。方法: 对该院内分泌科2020年的40~65岁T2DM住院患者进行回顾性研究。利用医院信息系统和电子病历系统收集患者临床相关资料, 根据是否伴有ASCVD病史分为无ASCVD病史组和伴ASCVD病史组, 分析其ASCVD预防用药及相关指标控制情况。结果: 共纳入254例患者, 其中无ASCVD病史组141例(55.5%), 伴ASCVD病史组113例(44.5%)。入院时血糖、血脂、血压均达标患者18例(7.1%); 出院时, 他汀类药物、抗血小板药、钠-葡萄糖协同转运蛋白2(SGLT-2)抑制剂、胰高血糖素样肽-1(GLP-1)受体激动剂的总体应用率均较入院前明显提高(P＜0.05), 与无ASCVD病史患者相比, 伴ASCVD病史患者应用他汀类、抗血小板药、GLP-1受体激动剂的应用率均显著偏高(P＜0.05), 而SGLT-2抑制剂的应用在两组间无统计学差异。结论: 该院40~65岁T2DM住院患者的ASCVD预防用药整体应用率较低, 与指南推荐存在一定差距, 且患者血糖、血脂、血压的控制达标情况较差, 提示临床应加强关注, 尤其是ASCVD一级预防。

Current status of ASCVD prevention in inpatients with type 2 diabetes mellitus aged 40 to 65 years in a hospital

OBJECTIVE To investigate the status of drug therapy for atherosclerotic cardiovascular disease (ASCVD) in inpatients with type 2 diabetes mellitus (T2DM) aged 40 to 65 years in Beijing Tongren Hospital, and to provide evidence for better drug therapy management.METHODS All T2DM inpatients aged 40 to 65 years who were admitted to the department of endocrinology of the hospital in 2020 were retrospectively analyzed. The hospital information system and electronic medical record system were used to collect the clinical data of patients. According to the history of ASCVD, the patients were divided into the group without ASCVD history and the group with ASCVD history. The application of ASCVD drugs and the control of related indicators were analyzed.RESULTS Totally 254 patients were included, and among them, 141 cases (55.5%) were without ASCVD history and 113 cases (44.5%) were with ASCVD history. At the time of admission, 18 patients (7.1%) met the standards for blood glucose, blood lipid and blood pressure. At discharge, the overall application rates of statins, antiplatelet agents, sodium-glucose cotransporter 2 (SGLT-2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists were significantly higher than those before admission (P < 0.05); at the mean time, compared with the patients without ASCVD history, the patients with ASCVD history had significantly higher application rates of other drugs except SGLT-2 inhibitor (P < 0.05).CONCLUSION The overall application rate of ASCVD preventive medications for T2DM inpatients aged 40 to 65 years old in this hospital is relatively low, and there is a certain gap between the guidelines recommended and the real world, and the control of blood glucose, blood lipid and blood pressure in the patients is poor. It is suggested that more attention should be paid, especially to the primary prevention of ASCVD.