Résumé
OBJECTIVE： To provide reference for improving the treatment compliance and therapeutic effect of patients with type 2 diabetes mellitus （T2DM） in China. METHODS： The follow-up data was from the issue of Pharmacoeconomic Study of Diabetic Drugs in China， which was conducted by China Center for Health Economic Research （CCHER） of Peking University. Using follow-up endpoint HbA1c level as clinical output indicator， univariate analysis and multivariable regression analysis of binary and numerical variables were performed to evaluate the effect of treatment compliance on short-term clinical outcomes. RESULTS： Totally 2 236 community T2DM patients were included for the analysis. The patients with good and poor medication compliance accounted for 23.48％ and 76.52％； the patients with good and poor blood glucose monitoring compliance accounted for 7.02％ and 93.98％； 66.3％， 23.5％ and 10.2％ of the patients had good， medium and poor diet control compliance， respectively. Univariate analysis showed that there was a significant difference in the “good control” group of blood glucose and the “poor control” group of blood glucose in terms of patient age， body mass index， education level， duration of disease， exercise， and eating habits，etc （P＜0.05）. Similar results were obtained in the analysis of multiple Logistic regression and multivariate loglinear regression models， that is， blood glucose monitoring compliance and diet control compliance had significant positive effects on end-point HbA1c （P＜0.05）， but drug compliance had no significant effect （P＞0.05）. CONCLUSIONS： The treatment compliance among community patients with T2DM in China was generally poor. After controlling for other variables， patients’ treatment compliance has a positive effect on end-point HbA1c， especially better blood glucose monitoring compliance and diet control compliance contribute to blood glucose control， but medication compliance has no significantly effect.
Résumé
BACKGROUND: The advantage of a laparoscopic cholecystectomy has led to a trend toward performing it in the elderly. It is well recognised that this can cause changes in respiratory mechanics. However, few studies have measured the effects of abdominal insufflation with CO2 in the elderly. This study was done to evaluate changes in respiratory compliance and peak airway pressure during a laparoscopic cholecystectomy. METHODS: Thirty patients undergoing a laparoscopic cholecystectomy were divided into two groups; aged 65 years or more (elderly group) and under 60 years (control group). A pneumoperitoneum up to an intraabdominal pressure of 12 mmHg was created with CO2 insufflation. Respiratory and peak airway pressure were measured with a continuous spirometry. Measurements were obtained pre-insufflation, just after CO2 insufflation, at 15, 30, 45 and 60 minutes and after abdominal deflation. RESULTS: In both groups, respiratory compliance decreased significantly (P < 0.05) and equally by about 40% after CO2 insufflation. The decrement continued during the pneumoperitoneum, the changes were not significant between the groups. Each group showed an equal improvement immediately after abdominal deflation. No differences between the peak airway pressure during a laparoscopic cholecystectomy was seen in either group. CONCLUSIONS: We have demonstrated that during a laparoscopic cholecystectomy in the elderly the respiratory compliance decreased and peak airway pressure significantly increased as in the control group.