摘要
目的研究生长抑素的长效类似物奥曲肽在糖尿病酮症酸中毒(DKA)治疗中的效果。方法共观察34例严重DKA患者,其中20例接受常规治疗,14例接受常规治疗加奥曲肽治疗,分别观察两组的血糖(BG)、β羟丁酸(-βHB)、非呼吸因素影响的pH(pHNR)、阴离子间隙(AG)、碳酸氢根(HCO3-)及急性生理学评分(APACHEⅡ)变化情况,以研究奥曲肽在DKA治疗中的效果。结果奥曲肽组较常规治疗组在BG缓解时间[(19.71±5.76)小时比(26.8±7.24)小时,P=0.006],β-HB缓解时间[(10.29±4.36)小时比(27.80±5.78)小时,P=0.000],HCO3-缓解时间[(12.00±4.15)小时比(18.20±5.43)小时,P=0.001],pHNR缓解时间[(14.00±5.14)小时比(19.80±4.40)小时,P=0.003]和AG缓解时间[(16.86±4.75)小时比(24.00±5.03)小时,P=0.001]差异均有统计学意义;患者APACHEⅡ评分在第12小时(12.29±3.38比14.17±3.24,P=0.166)差异无统计学意义,但在第24小时(8.05±2.99比10.00±2.69,P=0.01)差异有统计学意义。结论对严重或病情反复的DKA患者,常规治疗方法不能及时有效缓解患者病情时,加用奥曲肽有助于患者病情的控制。
Objective To evaluate the effects of long-acting somatostatin analogue (octreotide) on manifest diabetic ketoaeidosis (DKA). Methods The correction time of hyperglycemia, acidosis, aniongap ( AG), β-hydroxybutyrate(β-HB) and APACHE Ⅱ of patients treated with eonventlonal treatment (20 cases) against conventional treatment plus subcutaneous injection of octreotide(14 cases) was compared. Results Compared with conventional treatment group, the correction time in the octreotide group for hyperglycemia [ (19.71 ± 5.76) h vs (26.8 ± 7.24) h, P =0. 006],β-HB [(10. 29±4. 36) h vs (27.80±5.78) h, P =0. 000],AG [(16.86±4.75) h vs (24.00± 5.03) h, P =0. 0011 and pHNR[(14. 00±5. 14) h vs (19.80±4.40) h, P =0. 003] showed significant difference. At the 12 hour, APACHE Ⅱ had no significant difference between the two groups(12.29±3.38 vs 14.17±3.24, P = 0. 166). But at the 24 hour, the difference was significant (8.05±2.99 vs 10.00±2.69, P =0.01). Conclusion The addition of octreotide to conventional treatment of DKA might improve the correction of manifest DKA.
出处
《临床荟萃》
CAS
北大核心
2005年第17期961-963,共3页
Clinical Focus