上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (8): 956-.doi: 10.3969/j.issn.1674-8115.2010.08.021

• 论著（卫生事业管理） • 上一篇    下一篇

上海市1671例2型糖尿病患者社区管理的效果评价

田朝钊, 施 榕   

  1. 上海交通大学 公共卫生学院, 上海 200025
  • 出版日期:2010-08-25 发布日期:2010-08-27
  • 通讯作者: 施 榕, 电子信箱: shirong61@yahoo.com.cn。
  • 作者简介:田朝钊（1984—), 男, 硕士；电子信箱: tianzhaozhao@126.com。

Evaluation on effects of community management on 1 671 patients with type 2 diabetes mellitus in Shanghai

TIAN Zhao-zhao, SHI Rong   

  1. School of Public Health, Shanghai Jiaotong University, Shanghai 200025, China
  • Online:2010-08-25 Published:2010-08-27

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摘要：

目的 评价上海市2型糖尿病（T2DM）患者社区管理下的血糖控制效果。方法 随机抽取上海市6个社区卫生服务中心纳入上海市T2DM管理的1 671例T2DM患者进行问卷调查，将调查对象分为管理1组（血糖控制不佳组，n=725）和管理2组（血糖控制良好组，n=946）。建立多因素Logistic回归模型分析两组中空腹血糖（FBG）和餐后2 h血糖（PBG）的影响因素。结果 管理1组中T2DM患者FBG和PBG的平均浓度为（8.62±2.93）mmol/L和（11.51±3.95）mmol/L，管理2组中分别为（6.77±2.24）mmol/L和（9.22±2.88）mmol/L，两组与参考标准（FBG为7 mmol/L，PBG为10 mmol/L）比较，差异均有统计学意义（P<0.001）。Logistic回归分析表明：除病程外，管理1组FBG或PBG控制水平的影响因素为健康教育频率、制定运动方案、根据血糖调整饮食和运动；管理2组FBG或PBG控制水平的影响因素为社区医院转诊和执行饮食方案。结论 T2DM患者社区管理使患者血糖水平得到了一定程度的控制，社区卫生服务机构需重点加强对T2DM患者饮食、运动的干预和指导，加强对血糖控制较差患者的随访管理。

关键词: 2型糖尿病, 血糖, 社区管理, 效果评价, 上海市

Abstract:

Objective To evaluate the effects of community management on blood glucose control in patients with type 2 diabetes mellitus (T2DM) in Shanghai. Methods A total of 1 671 patients with T2DM randomly selected from 6 community health service centers with T2DM management in Shanghai were surveyed with questionnaires, and were divided into management group 1(poor in glucose control, n=725) and management group 2 (good in glucose control, n=946）. Influencing factors of fasting blood glucose (FBG) and postprandial 2 hours blood glucose（PBG）in two groups were analysed by multivariate Logistic regression analysis. Results FBG and PBG of patients in management group 1 were (8.62±2.93) mmol/L and (11.51±3.95) mmol/L respectively, those in management group 2 were (6.77±2.24) mmol/L and (9.22±2.88) mmol/L respectively, and both were significantly different from reference standard (7 mmol/L for FBG and 10 mmol/L for PBG)（P<0.001）. Logistic regression analysis revealed that duration of disease, frequency  of health education, design of exercise program and adjustment of diet and exercise were influencing factors on FBG or PBG of patients in management group 1, and duration of disease, two-way referral and administration of diet program were influencing factors on FBG or PBG of patients in management group 2. Conclusion Blood glucose of patients with T2DM may be under control in community, and community health service centers should conduct diet and exercise intervention and follow-up among patients with T2DM, especially for those with poor blood glucose control.

Key words: type 2 diabetes mellitus, blood glucose, management of community, effectiveness evaluation, Shanghai