北京海淀社区2型糖尿病患者用药现状调查及情况分析

崔芳囡; 汤欣; 牛红丽; 姜岳; 赵付英

doi:10.16766/j.cnki.issn.1674-4152.002641

北京海淀社区2型糖尿病患者用药现状调查及情况分析

doi: 10.16766/j.cnki.issn.1674-4152.002641

1.
中国人民大学医院内科，北京 100872
2.
北京市朝阳区高碑店社区卫生服务中心，北京 100024

基金项目:

首都卫生发展科研专项项目首发2018-3-7035

详细信息

通讯作者:
崔芳囡, E-mail: 13521272006@139.com

中图分类号: R587.1
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- 被引次数: 0
出版历程
- 收稿日期: 2021-05-09
- 网络出版日期: 2022-11-29

Investigation and analysis of drug use status of patients with type 2 diabetes in the Haidian community of Beijing

1.
Internal Department, Beijing Renmin University Hospital, Beijing 100872, China

摘要

摘要: 目的了解北京海淀区社区建档2型糖尿病(T2DM)患者的用药现状，分析合并用药的原因及多重用药的问题，为临床合理用药提供依据。方法选取在中国人民大学社区卫生服务中心建立T2DM慢病档案，在2020年1月1日—12月31日期间规律就诊6个月及以上的患者。记录患者的基本信息、确诊时间、合并疾病和用药。结果研究共纳入T2DM患者467例，男女性别比为1∶ 1.02，年龄为37~98岁，病程为0.5~37.5年，用药5(4, 7)种。419例患者采用药物控制血糖，41.77%(175/419)的患者使用单药降糖。72.55%(304/419)应用含二甲双胍的降糖方案，50.84%(213/419)应用含α-糖苷酶抑制剂的降糖方案，23.40%(98/419)应用磺脲类，22.91%(96/419)使用含胰岛素降糖方案，5.73%(24/419)应用二肽基肽酶Ⅳ(DPP-4)抑制剂类降糖方案；70.45%(329/467)的患者联合调脂治疗，54.39%(254/467)的患者联合抗血小板聚集药物治疗，74.73%(349/467)的患者服用降压药。60.17%(281/467)的患者同时服用5种及以上的药物。随着病程的延长，患者合并用药的数量逐渐增加，患者多重用药的种类与病程呈正相关(r=0.177，P＜0.001)。结论北京海淀区社区建档的T2DM患者多重用药普遍，存在医疗安全隐患，医生应对患者加强管理，优化用药方案，保证医疗安全。
- 2型糖尿病 /
- 调查 /
- 合并疾病 /
- 多重用药
Abstract: Objective To investigate the drug use status of type 2 diabetes (T2DM) patients in the Haidian District of Beijing, to analyse the reasons for the concomitant medication and the problem of polypharmacy, and to provide the basis for clinical rational drug use. Methods Patients who established the chronic disease file of T2DM in the community health service of the People ' s University of China and had been regularly visited for 6 months or longer between January 1, 2020 and December 31, 2020 were selected. The basic information of patients, the time of diagnosis of T2DM, comorbid diseases, and current medication were recorded. Results A total of 467 patients with T2DM were included in this study. The ratio of male to female was 1∶ 1.02, the age was 37 - 98 years, the course of disease was 0.5-37.5 years, and the medication was 5 (4, 7) species. Amongst them, 419 patients used drug intervention to control blood glucose, and 41.77% (175/419) patients used single-drug hypoglycaemic therapy. A total of 72.55% (304/419) patients used metformin containing hypoglycaemic regimen, 50.84% (213/419) patients were treated with α-glucosidase inhibitor, 23.40% (98/419) patients used sulphonylurea, 22.91% (96/419) patients used insulin, and 5.73% (24/419) patients used dipeptidyl peptidase 4 inhibitor. A total of 70.45% (329/467) patients used lipid-lowering therapy, 54.39% (254/467) patients continued to use antiplatelet aggregation drugs therapy, and 74.73% (349/467) patients used a combination of antihypertensive drugs. A total of 281 patients (60.17%) took five or more drugs at the same time for a long time. With prolonged disease course, the number of combined medications increased gradually, and the number of concomitant medications was positively correlated with the duration of diabetes (r=0.177, P < 0.001). Conclusion In the Haidian community of Beijing, T2DM patients with multiple-drug use are common, and hidden medical risks exist. Doctors should strengthen the management of patients, optimise the medication plan, and ensure medical safety.
- Type 2 diabetes /
- Investigations /
- Co-morbidity /
- Multiple-drug use

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表 1 不同年龄段T2DM患者病程[M(P₂₅, P₇₅)，年]

Table 1. Disease course of T2DM patients in different age groups [M(P₂₅, P₇₅), years]

年龄段(岁)	例数	男性		女性
年龄段(岁)	例数	例数	病程	例数	病程
30~39	1	1	9.2	0
40~49	19	10	8.4(4.5, 10.5)	9	7.1(5.5, 9.5)
50~59	94	51	6.7(2.5, 12.5)	43	8.6(5.2, 12.5)
60~69	165	92	9.9(5.6, 16.1)	73	8.9(5.8, 12.5)
70~79	113	44	13.0(6.6, 18.1)	69	11.5(7.5, 17.5)
80~89	65	28	15.8(8.7, 20.9)	37	11.5(7.5, 19.5)
90~99	10	5	14.5(13.5, 15.2)	5	10.1(9.5, 19.5)
合计	467	231	10.5(5.0, 15.6)	236	9.5(6.6, 14.5)

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表 2 T2DM患者合并用药品种及病程差异

Table 2. Different drug types and course of disease in patients with T2DM

合并用药数量	男性(例)	女性(例)	合计(例)	病程[M(P₂₅, P₇₅)，年]	百分比(%)
非药物干预	1	5	6	9.0(6.2, 12.5)	1.28
1种	6	6	12	9.1(4.3, 13.7)	2.57
2种	21	12	33	10.5(6.6, 14.5)	7.07
3种	30	27	57	8.6(3.8, 15.5)	12.21
4种	35	43	78	8.5(5.3, 11.5)	16.70
5种	42	47	89	10.5(6.1, 14.5)	19.06
6种	39	25	64	10.6(6.6, 15.6)	13.70
7种	20	33	53	12.5(7.2, 17.5)	11.35
8~9种	26	30	56	11.6(7.1, 18.5)	11.99
10种以上	11	8	19	15.1(12.5, 19.5)	4.07
合计	231	236	467		100.00

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表 3 不同性别间T2DM患者合并用药情况

Table 3. Combination of drug use in T2DM patients of different genders

联合用药		男性(例)	女性(例)	合计(例)	百分比(%)	χ²值	P值
降糖药	用药	211	208	419	89.72	1.970	0.374
	不用药	20	28	48	10.28
降压药	用药	173	176	349	74.73	0.006	0.938
	不用药	58	60	118	25.27
调脂药	用药	157	172	329	70.45	0.914	0.339
	不用药	70	63	133	28.47
抗血小板聚集药	用药	127	127	254	54.39	0.041	0.839
	不用药	104	108	212	45.39

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表 4 不同性别间T2DM患者使用不同种类降糖药治疗的情况(例)

Table 4. The use of different types of hypoglycemic agents in T2DM patients of different genders

降糖药种类	例数	男性	女性
非药物干预	48	20	28
单种降糖药组	175	84	91
磺脲类	6	5	1
双胍类	109	58	51
α-糖苷酶抑制剂	48	16	32
格列奈类	4	1	3
噻唑烷二酮类	0	0	0
DDP-4	1	0	1
胰岛素	8	5	3
多种降糖药组	244	127	117
双胍类+α-糖苷酶抑制剂	56	25	31
α-糖苷酶抑制剂+磺脲类	14	4	10
双胍类+α-糖苷酶抑制剂+磺脲类	29	17	12
胰岛素为基础的降糖方案	88	52	36
其他	57	29	28
合计	467	231	236

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