应用诺和锐和诺和灵R治疗儿童Ⅰ型糖尿病的疗效观察

Effective observation of insulin aspart and regular insulin on children with type Ⅰ diabetes mellitus

目的总结和分析胰岛素泵持续皮下输注超短效胰岛素类似物(诺和锐)及短效胰岛素(诺和灵-R)治疗儿童Ⅰ型糖尿病的疗效观察。方法将2004年5月至2008年6月我院内分泌科收治的Ⅰ型糖尿病患儿20例随机分为两组各10例,分别给予持续皮下胰岛素泵输注诺和锐和诺和灵R,观察并比较两组患儿血糖控制的时间、低血糖发生情况、每日胰岛素用量、餐前血糖(PBG)、餐后2h血糖(FBG)和睡前血糖。结果诺和锐组血糖控制时间较诺和灵-R组明显缩短[分别为(5.0±0.8)dvs(6.2±1.9)d、P<0.05];诺和锐组的平均每天胰岛素用量较诺和灵-R组显著减少[分别为(1.06±0.53)u·kg-1·dvs(1.48±0.89)u·kg-1·d,P<0.05];诺和锐组的餐后2h血糖较诺和灵-R组显著降低[分别为(8.08±2.12)mmol/Lvs(8.85±2.94)mmol/L,P<0.05]。两组患儿餐前血糖、睡前血糖和低血糖发生次数方面比较差异无统计学意义(P>0.05)。结论应用胰岛素泵注射诺和锐具有血糖控制迅速,餐后血糖控制更理想,注射后可立即进餐,更适应儿童生活之优点,且未出现明显不良反应,是目前Ⅰ型糖尿病患儿胰岛素泵治疗中满意的胰岛素类型。

Objective To compare the therapeutic effects of insulin aspart and regular insulin in continuous subcutaneous insulin infusion by insulin pump（ CS Ⅱ ） for children with typeⅠ diabetes mellitus. Methods Totally 20 cases of type Ⅰ diabetes mellitus were randomly assigned into two groups, one group used insulin aspart（ novo rapid） in CS Ⅱ was named as novo group（ n = 10） and the other group used normal human insulin（ novolin R） in CSⅡ was named as novolin group（ n = 10）. Two groups were examined peripheral blood glucose. The differences in blood glucose control time, the rate of hypoglycemic episodes, insulin dosage, PBG, FBG and prebedtime blood glucose were compared in the two groups. Results The time for well controlled blood glucose levels in novo group were shorter than that in novolin group [ novo group （ 5.0 ± 0. 8 ） d, novolin group （6.2 ± 1.9） d, P 〈 0. 05 ], the insulin dosage needed for well controlled blood glucose level in novo group were lower than that in novolin group [ novo group （1.06 ±0. 53）u·kg^-1·d, novolin group（1.48±0. 89） u·kg^-1·d, P 〈0.05], FBG in novolin group were better than that in novolin group[ novo group （8.08± 2. 12 ）mmol/L novolin group （8.85± 2.94 ）mmol/L, P 〈 0.05 ], hypoglycemie episode in two groups had no difference （ novo group （ 0. 3 ± 0.25 ） time/people, novolin group（0. 3 ±0.28） time/people, P 〉 0.05 ）, PBG in two groups had no difference （novo group （6.33 ±1.98 ） mmol/L, novolin group（6. 36± 2. 12）mmol/L, P 〉 0. 05 ）. Prebedtime blood glucose in two groups had no difference （ novo group （ 6.66± 3.00 ） mmol/L, novolin group （ 6.69± 2.90 ） mmol/L, P 〉 0. 05 ）. ConclusiOn The well controlled blood glucose could be gotten by the insulin aspart （novo rapid） in CS il. There are more strong point by use of the insulin aspart（ novo rapid） , such as, after injection of insulin aspart, children with type Ⅰ diabetes mellitus can eat at once, with rare adverse reaction. It is a good choice for type Ⅰ diabetes mellitus with CS Ⅱ therapy.