甘精胰岛素治疗老年危重患者合并高血糖40例临床分析

Glargine insulin therapy in 40 cases critically ill elderly patients with high blood sugar Clinical Analysis

目的探讨甘精胰岛素对老年危重患者合并高血糖的临床疗效。方法选择老年危重患者合并高血糖患者78例，随机分为2组，治疗前两组患者24h血糖为（13．8±4．5vs13．8±4．2）mmol／L，治疗组（n=40）采用甘精胰岛素作为基础治疗药物，对照组（n=38）采用中性低精蛋白锌人胰岛素作为基础治疗药物。可进食患者餐前追加短效胰岛素。血糖控制目标为5．0～8．0mmol／L。结果治疗组1，3，5d的平均血糖较对照组降低，分别为（12．2±1．4vs13．5±3．8）mmol／L，P〈0．01，（8．3±0．6VS9．5±0．8）mmol／L，P〈0．01，（5．8±0．2vs6．4±0．6）mmol／L，P〈0．05。7d及以后，两组间血糖无统计学差异。结论以甘精胰岛素为基础胰岛素的治疗方案能有效控制老年危重合并高血糖患者的血糖水平，有确切临床意义，值得临床推广使用。

Objective To investigate insulin glargine in elderly critically ill patients with the clinical effect of high blood sugar. Methods The elderly critically ill patients with hyperglycemia in patients with 78 cases,were randomly divided into 2 groups, two groups of patients before treatment for 24-hour blood glucose （ 13.8 ±4. 5vs13.8 ± 4. 2） mmol/L,the treatment group（n =40） using Gan refined as the basis of insulin treatment in the control group（ n = 38）low neutral protamine zinc insulin as a basic medication. Patients can eat hors d＇additional short-acting insulin. Blood sugar control target of 5.0 - 8.0 mmol/U Results The treatment group 1,3,5 d the average blood glucose lower than the control group, respectively （ 12. 2 ± 1.4vs13.5 ±3.8 ）mmol/L, P〈0.01,（8.3±0.6vs9.5±0.8）mmol/ L,P〈0.01,（5.8 ±0.2vs6.4±0.6）mmol/L,P〈0.05. 7 d and beyond,between the two groups was no significant difference in blood glucose. Conclusion Insulin glargine insulin-based treatment programs can effectively control blood glucose in elderly critically ill patients with high blood sugar levels, have the exact clinical significance, it is worth for clinical use.