【摘要】 目的了解北京市不同区域社区T2DM患者在血糖达标治疗过程中,《国家基本药物目录》中降糖药物（下称"国家基本降糖药物"）使用现状及更改原因,为推进社区T2DM患者管理的进程提供依据。方法纳入北京市4个社区卫生服务中心的T2DM患者900例。以HbA₁c<7%为目标,随访1年后分析其对国家基本降糖药物使用状况及更改的原因。结果随访1年后,7种国家基本降糖药物更改原因构成比比较,差异无统计学意义（χ²=25.176,P=0.396）,原因主要为血糖控制不佳（63.6%）和个人因素（28.9%）;随访1年后,磺脲类药物被更改的比例最高（51.1%）。结论北京社区T2DM患者更改国家基本降糖药物的主要原因是血糖控制不佳,但也易因个人因素更改,依从性欠佳。磺脲类药物更易被患者更改。更多还原

【Abstract】 Objective To investigate the reasons for the changes of the antidiabetic drugs in national essential medicine list among patients with type 2 diabetes mellitus（T2DM） during the process of blood glucose control in Beijing different communities.Methods 900 patients with T2 DM were enrolled from four community health service centers in Beijing.The target of blood glucose control was HbA₁c<7%.After 1 year follow-up,the data of the reasons for which the patients changed the drugs were performed to analysis.Results The ratio of the patients who changed the antidiabetic drugs in the national essential medicine list was 31.5%（305/969）.After 1 year follow-up,there was no significant difference among the constitution ratio of the reasons for the changes of 7 antidiabetic drugs in the national essential medicine list（χ²=25.176,P = 0.396）.The main reasons that patients changed the antidiabetic drugs were the poor blood glucose control（63.6%） and personal factors（28.9%）.During follow-up,the ratio of the change of sulfonylureas（51.1%） was the biggest,others in turn were biguanides（34.6%）,insulin（34.2%）,and glycosidase inhibitors（28.3%）.Conclusion The main reason for the changes of the antidiabetic drugs in the national essential medicine list is the poor control of blood glucose,and then personal factors.The ratio of the change of sulfonylureas is high in T2 DM patients in Beijing communities.更多还原