胰岛素泵在老年糖尿病酮症治疗中临床应用.docVIP

胰岛素泵在老年糖尿病酮症治疗中临床应用[摘要] 目的:比较短期胰岛素泵连续皮下胰岛素输注(CSⅡ)和静脉连续胰岛素输注(CVⅡ)在老年糖尿病酮症治疗中的效果及安全性。方法:120例老年糖尿病酮症患者分为两组,CSⅡ组和CVⅡ组各60例。结果:CSⅡ组血糖达标时间(7.82±2.60) d明显少于CVⅡ组(9.88±1.80) d、β-羟丁酸恢复正常时间(23.0±4.3) h较CVⅡ组(32.5±5.4) h 有明显缩短,胰岛素用量(44.6±5.8) U/d明显少于CVⅡ组(56.1±6.8) U/d、低血糖发生率(0.65±0.38)次/例较CVⅡ组(1.42±0.45)次/例有明显差别;3个月后糖化血红蛋白和胰岛素用量差异仍有显著性。结论:CSⅡ能更快、更有效、更安全地控制血糖,纠正代谢紊乱,且具有较好的中长期效果。 [关键词] 糖尿病酮症;老年;胰岛素泵;连续皮下注射 [中图分类号] R587.2[文献标识码]A [文章编号]1673-7210(2009)07(a)-107-02 Clinical application of insulin pump in treatment of aged diabetic ketoaciduria WANG Yihui, ZHAO Wensheng , CHENG Kanglin (Department of Endocrinology , the Sixth Affiliated Hospital of Sun Yat-sen University,Guangzhou 510655, China) [Abstract] Objective: To compare the therapeutic efficacy and safety between continuous subcutaneous insulin infusion(CSⅡ)and continuous intravenous insulin infusion (CVⅡ) in treatment of elderly patients with diabetic ketoaciduria. Methods: 120 elderly patients with diabetic ketoaciduria were randomly divided into two groups, one was CSⅡgroup by a portable insulin pump(60 cases), the other was CVⅡgroup(60 cases). Results: The glucose level ,therapeutic time[(7.82±2.60) d vs(9.88±1.80) d], the time to normal ketonuria[(23.0±4.3) hvs(32.5±5.4) h], insulin dosage [(44.6±5.8) U/dvs(56.1±6.8) U/d], and the rate of hepoglycemia [(1.42±0.45) vs (0.65±0.38)] ofCSⅡgroup were better than CVⅡgroup, the insulin dosage and HbA1c of CSⅡ group were significantly lower with CSⅡ group after 3 months. Conclusion: CSⅡ can control the hyperglycemia more quickly and effectively and reduce the hypoglycemia risk, and it can rapidly correct metabolic disorder,and the efficacy last longer to medium or long term. [Key words] Diabetic ketoaciduria; Elderly; Insulin pump; Continuous subcutaneous 胰岛素泵连续皮下胰岛素输注(CSⅡ)能模拟胰岛素基础分泌和进餐时的脉冲式释放,使胰岛素释放更符合生理性,具有更灵活方便的给药方式,较传统小剂量胰岛素静脉连续输注(CVⅡ)治疗糖尿病酮症有更理想的疗效。本组研究对120例老年糖尿病酮症患者分别用CSⅡ和CVⅡ进行胰岛素治疗,比较2种方法在老年糖尿病酮症中的疗效及安全性。 1 资料与方法 1.1 一般资料 选择我院2004年1月～2008年8月