【摘要】 目的探讨多因素强化干预对新诊2型糖尿病患者生活质量、代谢指标达标率及药物成本效果比的影响。方法采用健康调查表SF36对127例多因素强化干预及125例常规干预的2型糖尿病患者进行问卷调查,比较两组患者干预治疗前与干预治疗半年后生活质量的变化及血糖、血脂和血压的达标情况,对影响生活质量的某些因素进行多元逐步回归分析;并用成本效果分析法对两组进行药物经济学评价。结果强化干预组血糖、血脂、血压和总的达标率显著高于常规干预组(P<0.05);强化干预组的躯体角色功能、一般健康感、生命活力、情感角色功能和综合评分均明显高于干预前(P<0.05),干预治疗半年其VT评分和健康变化自评也优于常规组,而常规干预组干预治疗前后生活质量的各纬度评分无显著变化;生活质量综合评分干预治疗前后的差值与糖化血红蛋白的差值有关;强化干预组的降糖、调脂和降压的总成本效果比和有关生活质量的总成本效果比亦高于常规干预组。结论多因素强化干预方案可提高新诊2型糖尿病患者血糖、血脂和血压达标率,改善其生活质量,并且比常规干预方案更经济。更多还原

【Abstract】 Objective To explore the effects on quality of life (QOL), the targeted rates of metabolic parameters and cost-effectiveness in newly diagnosed type 2 diabetic patients who underwent multifactorial intensive intervention. Methods One hundred and twenty seven cases in an intensive intervention and 125 cases in a conventional intervention group were investigated by using the SF-36 questionnaire. The comparison of QOL and the targeted rates of metabolic parameters between the two groups were made. We assessed the influence factors of QOL by stepwise regression analysis and evaluated the efficiency by pharmacoeconomic cost-effectiveness analysis. Results The targeted rates of blood glucose, blood lipid and blood pressure with intensive policies were significantly higher than those with conventional policy (P<0.05). The ~intensive group’s role limitations due to physical problems (RP), general health (GH), vitality (VT), role limitation due to emotional problems (RE) and total scores after 6 months intervention were significantly higher than those of baseline (P<0.05). The vitality scores and health transition (HT) of the intensive group were better than those of the conventional group after 6 months intervention. But the QOL scores of the conventional group were not improved after intervention. The difference of QOL’s total scores after intervention was related to that of HbA1c. The total cost-effectiveness rate of blood glucose, blood lipid, blood pressure control and the total cost-effectiveness rate of QOL with intensive policy were higher than those with the conventional policy. Conclusions Quality of life and the targeted rates of blood glucose, blood lipid and blood pressure in newly diagnosed type 2 diabetic patients with multifactorial intensive intervention policy are better and more economic than those with conventional policy.更多还原