一体化管理对社区糖尿病患者糖化血红蛋白和血脂的影响研究

目的评价社区糖尿病一体化管理对糖尿病患者糖化血红蛋白(HbA1c)和血脂控制的效果,为糖尿病患者社区管理个体化方案提供依据。方法将入选的糖尿病患者分为试验组138例和对照组139例,对照组按照传统分组管理模式,社区公共卫生医生按组定期随访,患者自主就诊;试验组在此基础上,加强全科医生、糖尿病专科医生参与,实现"公共卫生医生-全科医生-专科医生"一体化无缝式管理模式,随访1年,比较两组的HbA1c和血脂指标的变化。结果与对照组比较,干预后试验组的平均HbA1c较对照组净下降0.89%,差异有统计学意义(P<0.01);血清三酰甘油(TG)明显下降,差异有统计学意义(P<0.01);血清总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)和低密度脂蛋白胆固醇(LDL-C)没有明显变化,差异无统计学意义(P>0.05)。结论一体化管理模式在改善HbA1c和血脂(特别是TG)方面存在更明显的优势。

Impact of Integral Management on HbA1c and Lipemia in Community Diabetics

Objective To assess the effect of integral management on glycosylated hemoglobin(HbA1c) and lipemia in community diabetics,so as to provide basis for individualized management of diabetes mellitus in community.Methods The selected diabetics were divided as trial group(n=138) and control group(n=139).The patients in the control group were given management on traditional grouping mode: community doctors do routine visit for patients or patients come to see doctors themselves,while those in the control group were given additional integral management of the participation by general practitioners and diabetes specialists,or mode of community doctor-general practitioner-specialists.The follow-up was conducted for one year and the changes of HbA1c and lipemia in the two groups were compared.Results Compared with the control group,in the trial group the HbA1c decreased by 0.89%(P<0.01),and triglyceride decreased greatly(P<0.01).But no statistical difference was found in total cholesterol,high density lipoprotein-cholesterol,and low density lipoprotein-cholesterol between the two groups.Conclusion Integral management mode has more advantages on improvement of HbA1c and lipemia,especially on triglyceride.