皮下胰岛素泵治疗糖尿病酮症酸中毒疗效及对氧化应激的影响

Clinical efficacy and effects of continuous subcutaneous insulin infusion with insulin pump on oxidative stress in patients of diabetic ketoacidosis

目的:探讨皮下胰岛素泵对糖尿病酮症酸中毒(DKA)患者的治疗效果及对氧化应激的影响。方法:60例DKA患者随机分为观察组和对照组,各30例。观察组通过胰岛素泵进行胰岛素持续皮下注射治疗,对照组采用胰岛素持续静滴。观察两组患者治疗前、后空腹血糖(FBG)、餐后血糖(PBG),血糖达标时间,低血糖情况,尿酮体转阴时间,pH值恢复时间,胰岛素用量及氧化应激指标超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-PX)及总抗氧化能力(TAC)变化。结果:两组患者治疗后FBG、PBG均较治疗前显著降低,但两组间差异不明显(P>0.05);观察组患者血糖达标时间、低血糖发生率、尿酮体转阴时间、pH恢复时间及胰岛素用量等均明显低于对照组(P<0.05)。两组患者治疗后MDA、SOD、GSH-PX和TAC水平均显著改善,但观察组MDA水平降低更显著(P<0.05),SOD、GSH-PXTAC水平升高更显著(P<0.05)。结论:皮下胰岛素泵持续输注治疗DKA血糖达标时间短、尿酮体转阴快、pH恢复迅速,胰岛素用量少,低血糖发生率低,氧化应激状态改善。

Objective：To investigate the effects of Clinical Efficacy and effect of continuous subcutaneous infusion with insulin pump on oxidative stress in patients of diabetic ketoacidosis.Methods：A total of 60 diabetic ketoacidosis patients were divided into observation group（30cases）and control group（30cases）.Control group was treated by continuous intravenous insulin infusion,while observation group was treated by continuous subcutaneous insulin infusion.Blood glucose target time,hypoglycemia,the time of urine ketone turning to negative,PH recovery time,dosage of insulin and oxidative stress（MDA,SOD,GSH-PX）were observed and compared after treatment.Results：Blood glucose target time,the rate of hypoglycemia,the time of urine ketone turning to negative,PH recovery time and dosage of insulin in observation group were significantly lower than those in control group（P0.05）.The level of MDA in observation group was significantly lower than control group after treatment（P0.05）,and SOD and GSH-PX levels in observation group were significantly higher than control group after treatment（P0.05）.Conclusion：Continuous subcutaneous infusion with insulin pump can reduce blood glucose target time,the urine ketone turning to negative time,PH recovery time,dosage of insulin and the rate of hypoglycemia,improve oxidative stress.