健康管理对2型糖尿病患者血糖控制干预效果的评价

目的 分析健康管理对2型糖尿病患者血糖控制的影响，探讨针对糖尿病患者不良生活方式切实有效的健康管理措施。方法 回顾性分析2003年3月至2007年7月经健康体检科确诊的1152例2型糖尿病患者的体检资料，包括生化指标如空腹血糖（GLU）、糖化血红蛋白（HbA1c）和每位患者既往的身体活动、饮食与遵医依从性等生活方式调查问卷，建立标准，进行评价，据此，将生活方式相对较好的283例（A组）和较差的869例（B组）患者纳入队列，进行队列研究，分析生活方式与糖尿病控制效果的关系；同时，将其中完整接受1年强化健康管理（包括饮食、运动、遵医依从性、健康教育等）的241例患者的管理前（c组）和管理后（D组）生化结果进行比对。结果 A组GLU和HbA1c的控制满意率分别为60．1％和56．5％，明显优于B组的49．0％和45．5％（Х^2=10．44和11．05，P〈0．01）；不科学的生活方式是糖尿病GLU和HbA1c控制不满意的危险因素（RR=1．28和1．25）；D组营养与运动知识总知晓率（63．5％）明显高于C组营养与运动知识总知晓率（25．7％），二者差异具有统计学意义（Х^2=4．51，P〈0．05），强化生活方式管理后GLU和HbA1c的控制满意率分别为61．8％和64．3％，明显优于管理前的58．5％和47．8％，二者差异具有统计学意义（Х^2=7．94和4．18，P〈0．01和0．05）。结论 生活方式与2型糖尿病血糖的控制效果密切相关，健康管理能够培养患者良好的生活方式，帮助患者获得满意的血糖控制效果。

An effectiveness evaluation of health management intervention on blood glucose control for 2 diabetic

Objective To analysis the influence of health management intervention on blood glucose control for 2 diabetic, discusses in view of the diabetic not good life style practice the effective health management measure. Methods Reviewed the diagnosised 2 diabetic examples （1152 ）from March ,2003 to July ,2007 by healthy physical examination and the physical examination materials, including the biochemistry items like fasting blood glucose （GLU）, Glucosylated hemoglobin （HbAlc） and the questionnaires about each patient＇s formerly body activity, the diet and the medical compliance etc. Established the standard, carried on the appraisal. According to the above, the life style relative good 283 examples （A group） and the bad 869 examples （B group） the patient will integrate the cohort, carried on the cohort study, analysised the relations between life style and diabetes controll effectiveness; At the same time, compared the biochemistry results between the non-managed （C group ） and the managed （D group ） after by meanse of a year strengthened health management intervention （ diet, movement, medical compliance, health education etc. ） on the 241 example patients. Results The GLU and HbA1c control satisfaction rate of the life style relative good group＇s （A group） respectively is 60. 1% and 56. 5%, obviously surpasses the life style bad group＇s （B group） 49. 0% and 45.5% Х^2 = 10. 44 and 11.05, P 〈0. 01） ; The unscientific life style is diabetes GLU and the HbA1 c control not satisfactory the dangerous fact （RR = 1.28 and 1.25） ; After carries on the life style strengthening intervention for a year （D group）, the nutrition and the movement knowledge awareness rate （63.5 % ） is obviously higher than the before management （C group ） （25.7 % ）, the difference has statistics significance （ Х^2 = 4.51, P 〈 0. 05 ） , after and before the strengthening life style management intervention, GLU and HbA1c control satisfaction rate is respectively 61.8%, 64.