持续皮下胰岛素注射治疗糖尿病合并与伴发心力衰竭患者37例疗效的观察

Therapeutic effect of the CSII treatment on the diabetic patients with congestive heart failure

目的比较不同给药方法对糖尿病合并与伴发心力衰竭疗效的影响。方法将74例糖尿病患者分为胰岛素泵持续皮下输注门冬胰岛素(CSII)组(静脉输注5%葡萄糖者,每4g葡萄糖增加基础量胰岛素1U)及多次皮下注射胰岛素(MSII)组4次/d。结果两组治疗24h平均血糖值、疗效、治疗后B型尿钠肽(BNP)及LVEF、低血糖事件发生率比较差异有统计学意义(P≤0.01)。结论 CSII治疗糖尿病合并与伴发心力衰竭疗效优于MSII。

Objective To compare the effect of different approaches of insulin administration on the in diabetic patients with congestive heart failure （CHF）. Methods The continuous subcutaneous insulin infusion （CSII） group was treated with insulin aspart infusion with insulin pump, for those who had intravenous infusion of 5% glucose, the initial basal rate of insulin aspart was increased by 1 U per 4 g glucose. The MSII group was treated with multi-subcutaneous insulin injection 4 times per day. Results The average BC- during 24 hour after receiving treatment, the efficacy, the B-type natriuretic protein （BNP）, the left ventrieular ejection fraction （LVEF）, and the incidence of hypoglycemia were significantly different between the two groups （P≤0. 01）. Conclusion The efficacy of the CSII therapy for the diabetic patients with CHF is superior to that of the MSII therapy.