胰岛素在合并感染的2型糖尿病患者中的临床应用-内科急危重症杂志.DOCVIP

合并感染的2型糖尿病患者胰岛素泵的临床应用 【摘要】目的 研究连续皮下胰岛素注射（CSII）对伴和不伴感染的2型糖尿病（T2DM）患者治疗的有效性。 方法 CSII感染组96例、CSII非感染组95例，均进行短期胰岛素强化治疗，比较两组血糖水平、血糖达标时间、单位体重胰岛素用量、低血糖发生率等，同时对伴和不伴感染的T2DM病人CSII应用方法进行比较。 结果 CSII感染组血糖达标时间为6.81±2.64天，非感染组为5.83±2.49天，CSII感染组达标时间较长（P＜0.05），且胰岛素用量较非感染组增加了约13%；感染组的CSII应用中主要是基础率水平较高；影响血糖达标和胰岛素用量的主要因素是感染、血糖水平和体质指数。 结论 CSII在合并感染的T2DM患者中能有效控制血糖，但胰岛素需要量增加，可通过增加凌晨和白天段的基础率来达到理想的血糖控制。 【关键词】感染，2型糖尿病，胰岛素泵 Clinical use of continuous subcutaneous insulin infusion in type 2 diabetes with infectious diseases 【Abstract】 Objective To compare the effects of continuous subcutaneous insulin infusion in the treatment of type 2 diabetes with or without infectious diseases. Methods Continuous subcutaneous insulin infusion (CSII) with infection group (n=96), CSII without infection group (n=95). Blood glucose levels, days needed for achieving good control, insulin dosage and hypoglycemic episodes were observed. We also compared the difference of insulin application between the two groups. Result The average durations reached the target blood glucose was longer in patients with infection compared with the patients without infection [(6.81±2.64) vs (5.83±2.49)d] (P＜0.05); and the insulin dosage increased about 13 percent in the former group. The insulin foundation rate in the patients with infectious diseases was higher than that in patients without infectious diseases. The major factors related to the average durations reached the target blood glucose and the insulin dosage were infection factor, blood glucose level and BMI. Conclusion CSII could achieve excellent glycemic control in type 2 diabetic patients complicated with acute infection, but the insulin dosage was increased. We can reach the expected blood glucose by increased the insulin dosage of daybreak and daytime. 【key words】type 2 diabetes, infection, insulin pump 持续皮下胰岛素注射（continuous subcutaneous insulin infusion, CSII）能模拟正常胰腺胰岛素的分泌模式，是糖尿病强化治疗的重要手段之一[1]，而感染是糖尿病常见的急性并发症，在感染应激状态下，CSII能否有效地控制血糖，尚未见报道。本文通过对我院伴和不伴感染的2型糖尿病（T2DM）患者C