胰岛素泵治疗糖尿病的临床研究

A clinical study on treatment of diabetes by continuous subcutaneous infusion with insulin pump

目的比较不同胰岛素给药方法对高血糖治疗的差异。方法64例需胰岛素治疗的高血糖病人住院进行了二种胰岛素强化治疗：①胰岛素泵连续皮下输往治疗（CSII组：30例，含1型DM8例，2型DM22例）；②多次皮下注射胰岛素治疗（MSII组：34例，含1型DM7例，2型DM27例）。二组治疗靶血糖值均为三餐前及睡前末梢血糖≥3．6mmol／L且≤7.2mmol／L，并至少二天。结果二种治疗血糖中位数有显著性差异（CSII：7．1，MSII：7．9，P＜0．001），平均高血糖控制无数（CSII：14.5±4．7天，MSII：22.5±7.5天，P＜0.01）、胰岛素用量（CSII：0.79±0.22U·kg(-1)／d，MSII0．63±0．20U·k(-1)／d，P＜0．01）均有显著性差异，而CSII组低血糖发生率却低于MSII组（0．9±1．2次／人vs1．9±2．5次／人，P＜0．05）。结论CSII治疗更符合生理状态下胰岛素分泌，可较MSII更快更有效地控制高血糖，并减少低血糖发生。

Objective To compare the effects of two different ways of insulin delivery on hyperglycemia. Methods64 poorly controlled diabetic patients were studied by 2 methods of intensive insulin delivery: di Continuoussubcutaneous insulin infusion(CSII) group (n = 30) including 8 cases of type 1 DM, 22 cases of type 2 DM; ②Multiplesubcutaneous insulin injection(MSII) group (n =34) including 7 cases of type 1 DM, 27 cases of type 2 DM. The targetBGs for both groups were premeal and bedtime BGs≥3. 6mmol/L ≤7.2mmol/L for at least 2 days. Results Median ofBG was 7. 1 in CSII, was 7. 9 in MSII, P＜0. 001. The average durations of treatment (CSII: 14. 5±4. 7d,MSII: 22. 5±7. 5d, P＜0. 01)and insulin doses (CSII: 0. 79±0. 22U·kg(-1)/d, MSII: 0. 63±0. 20U·kg(-10)/d, P＜0.01) weresignificantly different. The hypoglycemia incidence in CSII was 0. 9±1. 2time/case, in MSII: 1.9±2. 5time/case (P＜0. 05). Conclusion Since CSII mimiced the physiological insulin secretion, which could control the hyperglycemia muchfaster and more effectively, and reduced the hypoglycemia risk.