胰岛素泵联合门冬胰岛素治疗糖尿病酮症酸中毒的临床研究

Clinical Observation of Continuous Subcutaneous Insulin Aspart Infusion Therapy in Patients with Diabetic Ketoacidosis

目的比较皮下连续输注门冬胰岛素与常规静脉小剂量胰岛素输注疗法治疗糖尿病酮症酸中毒的疗效。方法将52例糖尿病酮症酸中毒患者随机分为2组,胰岛素泵门冬胰岛素组(n=27)及常规静滴胰岛素组(n=25),观察纠正酮症酸中毒所需要的时间(h)和所需要的胰岛素量。结果纠正酮症酸中毒所用胰岛素量两组无明显统计学差异(P>0.05),而纠正酮症酸中毒所需要的时间在皮下连续输注门冬胰岛素组为16.8±2.4 h,常规静脉小剂量胰岛素组为19.7±2.8 h,皮下连续输注门冬胰岛素组明显低于常规静滴组,具有统计学意义(P<0.05)。结论采用皮下连续输注门冬胰岛素治疗糖尿病酮症酸中毒是安全有效的,可能对患者及早改善代谢紊乱状态有一定帮助。

Objective To compare the efficacy and safety of continuous subcutaneous insulin Aspart infusion therapy （CS） and a traditional low -dose intravenous（Ⅳ） infusion therapy of regular insulin in patients with diabetic ketoacidosis （DKA）. Methods A total of 52 consecutive patients admitted with DKA were randomly divided into two groups. CS （ n = 27 ） and IV group （ n = 25 ）. Observation parameter were the duration of treatment until correction of ketoacidosis and amount the insulin administration until correction of ketoacidosis. Results There was no statistical difference for the mean insulin amount of treatment until correction of DKA （ P 〉 0. 05 ）. There was significant difference for the mean duration of treatment until correction of DKA between CS group（ 16. 8 ±2. 4 h） and iv group（ 19.7 ± 2.8 h, P 〈 0. 05）. The duration of treatment until correction of DKA was shorter when patients were treated with insulin Aspart by insulin pump. Condusion Our results indicate that the use of continuous subcutaneous insulin Aspart is safe and effective. It may be helpful for correction of metabolic abnormality of DKA in shorter time.