CAJ | 학술논문

目的：了解2型糖尿病患者糖化血红蛋白（HbA1c）控制现状，分析治疗方案及与血糖控制的关系。方法采用横断面研究方法，以调查问卷形式收集患者年龄、病程、降糖药物使用情况等，并留取标本进行HbA1c、血糖、血脂等检测分析。入选2型糖尿病患者323例，平均年龄（55.80±13.36）岁，平均病程（3.41±5.18）年。结果（1）总体血糖控制状况：HbA1c＜7.00%占34.06%（110/323），65.94%（213/323）被调研者HbA1c不达标；（2）糖尿病病程与血糖控制状况：323例患者中糖尿病平均病程小于2年者最多（187例），病程小于3个月者HbA1c均值最高（9.48 mmol/L）；（3）自我血糖监测与血糖控制：仅21.98%（71/323）被调查者在过去1周曾进行自我血糖监测，HbA1c达标率为29.58%；（4）治疗方案与血糖控制：单纯口服药组达标率高于胰岛素组。起始用胰岛素治疗的主要原因为口服药疗效不佳[59.05%（137/167）]，患者自己要求注射胰岛素治疗者HbA1c控制状况最好，达标率为66.67%。使用人胰岛素组HbA1c控制情况较好；（5）伴随疾病与血糖控制：57.89%（187/323）被调研者有伴随疾病，伴随疾病组HbA1c控制状况较好。结论该院2型糖尿病患者仍有较大比例（65.94%，213/323）HbA1c未达标。胰岛素组患者HbA1c未达标比例明显高于单纯口服药物组。
목적：료해2형당뇨병환자당화혈홍단백（HbA1c）공제현상，분석치료방안급여혈당공제적관계。방법채용횡단면연구방법，이조사문권형식수집환자년령、병정、강당약물사용정황등，병류취표본진행HbA1c、혈당、혈지등검측분석。입선2형당뇨병환자323례，평균년령（55.80±13.36）세，평균병정（3.41±5.18）년。결과（1）총체혈당공제상황：HbA1c＜7.00%점34.06%（110/323），65.94%（213/323）피조연자HbA1c불체표；（2）당뇨병병정여혈당공제상황：323례환자중당뇨병평균병정소우2년자최다（187례），병정소우3개월자HbA1c균치최고（9.48 mmol/L）；（3）자아혈당감측여혈당공제：부21.98%（71/323）피조사자재과거1주증진행자아혈당감측，HbA1c체표솔위29.58%；（4）치료방안여혈당공제：단순구복약조체표솔고우이도소조。기시용이도소치료적주요원인위구복약료효불가[59.05%（137/167）]，환자자기요구주사이도소치료자HbA1c공제상황최호，체표솔위66.67%。사용인이도소조HbA1c공제정황교호；（5）반수질병여혈당공제：57.89%（187/323）피조연자유반수질병，반수질병조HbA1c공제상황교호。결론해원2형당뇨병환자잉유교대비례（65.94%，213/323）HbA1c미체표。이도소조환자HbA1c미체표비례명현고우단순구복약물조。
Objective To understand the control status of hemoglobin A1c (HbA1c) and analyze the relationship with glycemic control and treatment schedule. Methods The study was adopted the method of cross-sectional survey to collect the da-ta of age,diabetes duration and therapeutic management with hypoglycemic agent by questionnaire. The specimens were taken for determination and analysis of HbA1c,blood glucose,blood lipid and so on. Totally 322 patients with type 2 diabetes mellitus (T2DM) were selected with the average age of (55.80±13.36) years and the mean disease course of (3.41±5.18) years. Results (1)The overall glycemic control status:the patients with HbA1c<7% accounted for 34.06%(110/323),the HbA1c of other 65.94%respondents(213/323) failed to reach the control standard.(2)Investigation of duration of diabetes and glycemic control status:the cases with the mean disease course<2 years were most in the total 323 patients (187/323),and the mean HbA1c value of the patients with the mean disease course<3 months reached maximum(9.48 mmol/L).(3)Investigation of self monitoring of blood glucose and blood glucose control:only 21.98%respondents(71/323) monitored their blood glucose at home in the past week with the HbA1c standard rate of 29.58%.(4)Investigation of therapeutic regimen and glycemic control:the compliance rate in pure oral medicine group was higher than that in the insulin group. The main reason for starting insulin therapy was due to ineffective-ness of oral medication [59.05%(137/167)],and the control status of HbA1c in patients,who requested injection of insulin,was best with the standard rate of 66.67%. The control status of HbA1c in human insulin group was better. (5)Investigation of con-comitant diseases and blood glucose control:57.89%respondents(187/323) were with concomitant diseases,but the control status of HbA1c in concomitant disease group was in good condition. Conclusion The T2DM patients without targeted HbA1c in the hospital are still in a large proportion(65.94%,213/323). The substandard ratio in insulin group is significantly higher than that in the pure oral medicine group.