胰岛素泵持续治疗急性脑出血患者高血糖状态

Evaluation of Continuous Subcutaneous Insulin Infusion in Acute Intracerebral Hemorrhage Patients with Hyperglycemia

目的:比较胰岛素泵连续皮下输注胰岛素(CSII)与每日多次皮下注射胰岛素(MSII)对急性脑出血高血糖状态患者血糖控制及神经功能缺损改善的差异。方法:70例脑出血高血糖状态患者随机分为2组各35例,均接受急性脑出血常规处理,MSII组同时行MSII治疗,CSII组同时行CSII治疗,比较2组血糖控制情况,并于治疗前与治疗2周后使用美国国立卫生研究院脑卒中量表(NIHSS)评定2组神经功能。结果:与MSII组比较,CSII组血糖控制达到靶血糖值的时间缩短、胰岛素用量及低血糖的发生次数减少(P<0.05);2组治疗后NIHSS评分和死亡率均明显降低(P<0.05),而以CSII组更显著(P<0.01)。结论:与MSII比较,CSII更适用于治疗急性脑出血合并高血糖状态,能更有效地控制高血糖,改善神经功能。

Objective, The effects of continuous subcutaneous insulin infusion （CSII） by insulin pump and multi subcutaneous insulin injection （MSII） on hyperglycemia in patients with acute intracerebral hemorrhage have been evaluated. Methods： Seventy acute intracerebral hemorrhage patients with hyperglycemia were randomly divided into control group who were treated by MSII on the basis of routine methods, and the CSII group who were treated by CSII on the basis of routine methods. Blood glucose and scores of the National Institutes of Health Stroke Scale （NIHSS） before and after 2 weeks were documented. Results, After 2 weeks of therapy, the time needed for lowering blood sugar to targeting points was significantly shorter[（3.20 ±0. 91d）vs（5.12± 1.03d）], insulin dosage less amount[（38.6±8.5U/d）vs（51.6 ±10.1U/d）], and incidence of hypoglycemia much less （2 times vs 5 times） in CSII group than in MSII group. The scores of NIHSS after 2 weeks and the death incidence were significantly lower in the CSII group. Conclusions： CSII can help controlling the blood glucose and improve the neurological function better than MSII in treating acute intracerebral hemorrhage patients with hyperglycemia.