胰岛素泵联合动态血糖监测仪在儿童1型糖尿病治疗中的应用价值

Application of CSII combined with CGMS in children with type 1 diabetes mellitus

目的观察胰岛素泵(CSII)联合动态血糖监测仪(CGMS)(双C)在1型糖尿病(T1DM)儿童治疗中的应用价值。方法 T1DM患儿72例,在每日8次微量血糖仪血糖监测下采用CSII治疗。其中,25例加用CGMS(A组),47例未用CGMS(B组)。比较两组血糖稳定达标时间、低血糖事件(血糖<3.9mmol/L)发生次数和住院时间间的差异;分析两法所测血糖值之间的相关性。结果 A组血糖稳定达标时间明显短于B组[(3.96±1.02)dvs.(5.60±1.17)d](P<0.05);A组住院时间显著短于B组[(6.44±0.96)dvs.(7.79±1.33)d](P<0.05);发现低血糖事件A组高于B组[(2.60±1.19)次vs.(1.17±0.70)次](P<0.05)。CGMS所监测血糖值与手指血微量血糖仪所测血糖值呈正相关(r=0.905,P<0.01)。结论 CGMS和微量血糖仪均能指导CSII治疗儿童T1DM。采用双C指导治疗临床达标时间、住院时间短,但易发现低血糖事件。

Objective To investigate the application value of continuous subcutaneous insulin infusion（CSII） combined with continuous glucose monitoring system（CGMS） in children with type 1 diabetes mellitus（T1DM）.Methods CSII combined with fingertip blood glucose monitoring eight times a day was carried out in 72 T1DM children,of whom CGMS was used in 25 cases（group A） and CGMS was not used in 47 cases（group B）.The time to reach therapeutic goal,hypoglycemia event and hospital stay were compared between two groups.The correlation of blood glucose level measured by CGMS and fingertip blood monitoring was analyzed. Results Compared to group B,group A had shorter time to reach the therapeutic goal／[（5.60±1.17） d vs.（3.96±1.02） d／] and less hospital stay／[（7.79±1.33） d vs.（6.44±0.96） d／]（P0.05）,but more hypoglycemia events／[（2.60±1.19） times vs.（1.17±0.70） times／]（P0.05）.Blood glucose value reported by CGMS was positively correlated to that by fingertip blood monitor（r=0.905,P0.01）.Conclusion CGMS and fingertip blood glucose monitor can be used to guide CSII for controlling blood glucose level in T1DM children.CSII combined with CGMS has the advantages of shorter time to reach the therapeutic goal and less hospital stay,but with more hypoglycemia events.