CAJ | 학술논문

目的研究在现有医疗模式下糖尿病合并高脂血症患者血脂干预后的达标率与直接医疗成本.方法回顾性实境研究糖尿病管理数据库中随访超过1年的糖尿病合并高脂血症患者30例,从数据库检索治疗前后血脂情况,计算代谢指标达标率、药物费用,并根据糖尿病筛查路径计算年检查费用.结果 30例糖尿病患者合并高脂血症治疗后空腹血糖(FPG)、餐后2 h血糖(2 hPBG)、糖化血红蛋白(HbA_(1c))、高密度脂蛋白胆固醇(HDL-C)均有明显改善,与治疗前比较差异有统计学意义(P＜0.05).合并高脂血症患者中血脂达标为11人(36.7%).就诊过程中支付治疗药物的费用平均为6 307.1元/人·年,其中降糖药费用为4 897.9元/人·年;合并高脂血症患者降脂费用平均为1 928.0元/人·年.在血糖达标组中每降1% HbA_(1c)的降糖药费用平均为 4 615.3元/人·年.结论虽然糖尿病患者规范化管理有助于提高血糖及血脂的达标率,但现有的达标现状仍有待提高.目前效益目标为纠正代谢紊乱所带来的医疗费用仍比较高.但是该项研究寄希望于血糖、血脂长期达标使远期并发症发病率下降,就可以节省治疗并发症的费用而提高治疗效益.
목적 연구재현유의료모식하당뇨병합병고지혈증환자혈지간예후적체표솔여직접의료성본.방법 회고성실경연구당뇨병관리수거고중수방초과1년적당뇨병합병고지혈증환자30례,종수거고검색치료전후혈지정황,계산대사지표체표솔、약물비용,병근거당뇨병사사로경계산년검사비용.결과 30례당뇨병환자합병고지혈증치료후공복혈당(FPG)、찬후2 h혈당(2 hPBG)、당화혈홍단백(HbA_(1c))、고밀도지단백담고순(HDL-C)균유명현개선,여치료전비교차이유통계학의의(P＜0.05).합병고지혈증환자중혈지체표위11인(36.7%).취진과정중지부치료약물적비용평균위6 307.1원/인·년,기중강당약비용위4 897.9원/인·년;합병고지혈증환자강지비용평균위1 928.0원/인·년.재혈당체표조중매강1% HbA_(1c)적강당약비용평균위 4 615.3원/인·년.결론 수연당뇨병환자규범화관리유조우제고혈당급혈지적체표솔,단현유적체표현상잉유대제고.목전효익목표위규정대사문란소대래적의료비용잉비교고.단시해항연구기희망우혈당、혈지장기체표사원기병발증발병솔하강,취가이절성치료병발증적비용이제고치료효익.
Objective To investigate the control rate and the medical cost of the diabetic patients complicated by hyperlipidemia after the intervention of blood lipids,under the current health care model. Methods A retrospective study was performed for 30 patients with diabetes mellitus complicated by hyperlipidemia selected from the diabetes management database,who had been followed up for more than one year. The condition of blood lipids before and after the treatment was retrieved from the database. The metabolic control rate,the drug expenditure,and the examination cost of the whole year based on the diabetes screening path were calculated.Results The patients' levels of fasting plasma glucose,2-hour postprandial blood glucose,glycosolated hemoglobin Ale (HbA_(1c)),high-density lipoprotein (HDL-C) got improved after the treatment,with a significant difference (P<0.05). There were 11 patients (36.7%) who got lipid contro1 goal. The average total medical expenditure per year was RMB 6 307.1,including RMB 4 897.9 for diabetes and RMB 1 928.0 for hyperlipidemia. Among the patients who got the blood glucose control goal,the medical expenditure was RMB 4 615.3 to lower l% HbA_(1c). Conclusion Although the standard management of diabetes patients helps to improve the control rate of blood glucose and lipids,it remains to be improved. The current medical expenditure is still expensive for controlling the metabolic disorders. The aim of this study is to lower the incidence of remote complications by controlling the blood glucose and lipids,and thus the medical expenditure can be reduced and the therapeutic effect can be raised.