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目的 探讨基于社区的2型糖尿病患者强化管理模式的应用效果.方法 2010年6月至2011年12月,从杭州市米市巷街道的2型糖尿病患者中筛选出1 024例作为研究对象,按照所在社区进行分组,对照组501例,干预组523例.干预组采用糖尿病强化管理模式进行管理和健康干预,对照组采用一般社区糖尿病管理方法.采用t检验或x2检验比较强化管理前后糖尿病患者的空腹血糖、餐后2h血糖、糖化血红蛋白(HbA1c)、血压、血脂、体质指数等各项指标变化.结果 干预组与对照组患者相比,年龄比较差异无统计学意义(t=0.124,P＞0.05),两组间性别比较差异无统计学意义(x2=2.0,P＞0.05),其他基线资料差异也均无统计学意义,具有可比性(P均＞0.05).经过强化管理,干预组HbA1c、血压、血脂、体质指数的达标率分别为75.4％、30.4％、85.6％、49.0％,均显著高于对照组,差异均有统计学意义(x2=4.540、4.710、6.542、3.674,P＜0.05).干预组血三酰甘油、空腹血糖、餐后2h血糖分别为(1.5±0.9) mmol/L、(6.2±1.3)mmol/L、(8.3±2.4) mmol/L,均明显低于对照组,差异均有统计学意义(t=3.098、4.926、4.523,P＜0.05).结论 糖尿病强化管理模式在社区糖尿病综合干预管理中是一种有效的方法,有利于提高糖尿病的管理效果.

Objective To discuss the effectiveness of community-based intensified health management on type Ⅱ diabetes patients.Metbods From June 2010 to December 2011,1 024 type Ⅱ diabetes patients in Mishi Lane community were enrolled and assigned to the intervention group (n=501,obtaining intensive health management) and the control group (n=523,obtaining routine community health management).Fastingbloodglucose (FBG),2-hour postprandial blood glucose (PBG2h),HbA1c,blood pressure (BP),triglyceride (TG) and body mass index (BMI) were tested and recorded before and after the intervention.Student's t test or Chi-square test were used for data analysis.Results Differences of age (t=0.124,P＞0.05) and gender (x2=2.0,P＞0.05) were not statistically significant (both P＞0.05).Following the intensive health management,the control rates of HbA1c,BP,TG and BMI were increased to 75.4％,30.4％,85.6％ and 49.0％,respectively (x2 values were 4.54,4.71,6.54 and 3.67; all P＜0.05).TG,FBG and PBG2h of the intervention group were (1.5 ± 0.9),(6.2 ± 1.3) and (8.3 ± 2.4) mmol/L,respectively,which were significantly lower than those of the control group (all P＜0.05).Conclusion Community-based intensive health management could be effective for diabetes patients.