生长抑素在危重患者血糖控制中的作用

Effect of somatostatin on blood glucose control in critical patients

目的：探讨胰岛素联用生长抑素对危重患者血糖控制的优化作用。方法：危重患者145例,随机分为胰岛素控制组（A组）和胰岛素联用生长抑素组（B组）。血糖控制目标值为（4.4－11.1）mmol/L,2组患者均在血糖超过11.1 mmol/L时开始给予胰岛素静脉泵入,起始速度为0.1 U/（kg·h）,最大用量不超过0.5 U/（kg·h）。B组加用生长抑素0.1 mg皮下注射,1次/8 h。比较2组患者的血糖变异、血糖均值、胰岛素用量、血糖达标时刻、总达标时间、ICU住院时间。结果：B组的血糖变异、胰岛素用量、再感染率明显小于A组,达标时刻早于A组、ICU时间明显短于A组,总达标时间明显长于A组。2组血糖均值、多器官功能障碍综合征（MODS）发生率、病死率无统计学差异。结论：胰岛素联用生长抑素能优化危重患者的血糖控制。

Objective： To investigate the clinic effect of insulin combined with somatostatin on blood glucose control in critical patients. Methods： One hundred and forty-five critical patients were randomly divided into insulin control group（ group A） and insulin combined with somatostatin group（ group B）. Blood glucose control target was 4. 4 ~11. 1 mmol/L. Insulin was administered intravenously in both groups when blood glucose level was over 11. 1 mmol / L. Dosage of insulin ranged from 0. 1 U /（ kg·h） to 0. 5 U /（ kg·h）. Group B received somatostatin 0. 1 mg hypodermically once every 8 hours. Glucose variability,average level of blood glucose,total dosage of insulin,the time required to reach blood sugar target at the first time,the total time for reaching blood glucose target within 3 days and ICU stay time were compared between two groups. Results： Glucose variability,total dosage of insulin,and incidence of re-infection were less in group B than those in group A. Group B reached blood glucose target more quickly,and ICU stay in group B was shorter than that in group A. Group B necessitated a longer time for reaching blood glucose target. There were no statistical differences in average level of blood glucose,incidence of multiple organ dysfunction syndrome（ MODS） and mortality between two groups. Conclusions： Insulin combined with somatostatin is helpful in blood glucose control in critical patients.