瑞典初级保健中2型糖尿病患者的代谢控制与病历数据质量：1995年至2001年期间的改善情况

Metabolic control and quality of data in medical records for subjects with type 2 diabetes in Swedish primary care: improvement between 1995 and 2001.

作者信息

Wändell Per E, Gåfvels Catharina

机构信息

Family Medicine Stockholm, Karolinska Institutet, Stockholm, Sweden.

出版信息

Scand J Prim Health Care. 2002 Dec;20(4):230-5. doi: 10.1080/028134302321004890.

DOI:10.1080/028134302321004890

PMID:12564575

Abstract

OBJECTIVE

To compare the registering of diabetic complications and metabolic control in type 2 diabetic subjects in primary health care in 1995 and 2001.

DESIGN

Cross-sectional surveys of medical records.

SETTING

Two primary health care centres in Stockholm County.

SUBJECTS

Diabetic patients aged 35-64 years; in 1995, 59 men and 42 women and in 2001, 80 men and 80 women.

MAIN OUTCOME MEASURES

Rate of notified examinations in medical records, diabetic complications and metabolic control.

RESULTS

Increased rates between 1995 and 2001 were found regarding examinations for neuropathy (46% vs 79%), albuminuria (74% vs 91%), micro-albuminuria (11% vs 59%), BMI (33% vs 66%), HbA1c (88% vs 99%), cholesterol (69% vs 92%) and LDL cholesterol (42% vs 89%) (p < 0.001). Increased rates of perceived treatment goals between 1995 and 2001 were found regarding HbA1c (< 6.5%) (28% vs 57%) and cholesterol (< 5.0 mmol/l) (23% vs 36%) (p < 0.001), and also regarding LDL cholesterol (30% vs 36%) (p < 0.01). In men, the number of subjects with any macrovascular complication decreased between 1995 and 2001 (34% vs 17%) (p < 0.01), and in women the number of subjects with coronary heart disease decreased (26% vs 6%) (p < 0.01).

CONCLUSION

Documented examination rates and metabolic control improved between 1995 and 2001.

摘要

目的

比较1995年和2001年在初级卫生保健机构中2型糖尿病患者糖尿病并发症的登记情况及代谢控制情况。

设计

病历横断面调查。

地点

斯德哥尔摩县的两个初级卫生保健中心。

研究对象

年龄在35 - 64岁的糖尿病患者；1995年，59名男性和42名女性；2001年，80名男性和80名女性。

主要观察指标

病历中报告的检查率、糖尿病并发症及代谢控制情况。

结果

1995年至2001年期间，神经病变检查率（46%对79%）、蛋白尿检查率（74%对91%）、微量蛋白尿检查率（11%对59%）、体重指数（BMI）（33%对66%）、糖化血红蛋白（HbA1c）（88%对99%）、胆固醇（69%对92%）和低密度脂蛋白胆固醇（42%对89%）均有所增加（p < 0.001）。1995年至2001年期间，HbA1c（< 6.5%）（28%对57%）、胆固醇（< 5.0 mmol/l）（23%对36%）（p < 0.001）以及低密度脂蛋白胆固醇（30%对36%）（p < 0.01）的治疗目标达成率也有所增加。在男性中，1995年至2001年期间发生任何大血管并发症的患者数量减少（34%对17%）（p < 0.01），在女性中，患有冠心病的患者数量减少（26%对6%）（p < 0.01）。