胰岛素泵在1型糖尿病患儿的合理使用

Reasonable Application of Insulin Pumps in Children with Type 1 Diabetes

目的探讨胰岛素泵强化治疗对1型糖尿病(T1DM)患儿的疗效,并分析影响疗效和胰岛素用量的因素。方法本院内分泌科2003-2008年收治的T1DM患儿68例。对其进行短期胰岛素泵强化治疗,将其分为初诊组和复诊组、感染组和非感染组,并酮症酸中毒(DKA)和非DKA组,观察影响使用胰岛素泵治疗效果的因素,在年龄、初诊、感染和并DKA等情况下胰岛素泵的使用情况。结果68例患儿均予胰岛素泵强化治疗,血糖达标天数为(4.37±1.60)d,达标时胰岛素用量为(1.22±0.34)U/(kg.d);初诊组和复诊组血糖达标时间、胰岛素用量比较均无显著差异(Pa>0.05);非感染组达标时间明显均较感染组、并DKA组短(Pa<0.05);与非感染组比较,感染组、并DKA组基础胰岛素用量大(Pa<0.01),小年龄组胰岛素输注管堵塞和发生低血糖例次明显多于大年龄组儿童。结论胰岛素泵的使用在T1DM患儿存在着差别,小年龄组胰岛素泵使用要慎重。

Objective To explore the curative effects of the insulin pumps on type 1 diabetes（ T1DM） in children, and analyze the factors related to its efficacy and insulin dosage. Methods Sixty - eight cases with T1DM who were hospitalized in department of endocrinology of Nanjing Children＇s Hospital Affiliated to Nanjing Medical University from 2003 to 2008 were administrated in short - term insulin pumps therapy,and the effects were observed in different cases,such as infants,the newly diagnosed cases,and the cases combined with infection or ketoacidosis （ DKA）, respectively. Results The duration of blood glucose control was （4.37±1.60） days and the average dosage of insulin was （1.22±0.34） U/（ kg·d） in all patients. The dosage of insulin and the duration of blood glucose control showed no significant difference between the newly diagnosed group and the previously diagnosed group（ Pa〉0.05 ）. But the duration of blood glucose control was shorter in children without infection than those combined with infection or DKA（Pa〈0.05）. The cases combined with infection or DKA had a higher basal insulin dosage than those cases without infection （Pa〈0.01 ）. The incidence of hypoglycemia and blockade of the catheter was significantly higher in the infant cases. Conclusion The application of insulin pumps varied with different conditions and it is important to be used carefully in infant cases.