基于聚类分析的住院2型糖尿病患者胰岛素应用剂量分析

Insulin Dose in Hospitalized Patients with Type 2 Diabetes Based on Cluster Analysis

目的探讨住院2型糖尿病患者应用不同基础、强化胰岛素治疗方案并达到血糖控制目标时,胰岛素应用剂量与临床诊断、相关生化指标变化的关系。方法回顾性分析我院2012年~2014年住院治疗的312例2型糖尿病患者的临床诊断、相关生化指标检测结果和临床用药等资料。采用SPSS 19.0软件进行聚类分析,再将聚类分析结果与临床诊断、相关生化指标变化进行综合分析。结果临床诊断、相关生化指标共聚类成9类,相关分析结果显示单位体质量胰岛素与糖化血红蛋白、体质量指数、空腹C-肽差异均有统计学意义(P<0.05)。单位体质量胰岛素与糖化血红蛋白呈正相关,与体质量指数、空腹C-肽呈负相关。应用剂量分析显示应用不同基础、强化胰岛素治疗方案中,基础胰岛素应用剂量为0.189±0.105 U·kg^(-1),强化胰岛素应用剂量为0.622±0.183 U·kg^(-1),方差分析结果显示,类别间胰岛素应用剂量比较,差异无统计学意义(P>0.05)。结论胰岛素应用剂量与临床诊断、相关生化指标变化密切相关。

OBJECTIVE To explore the relation between the dosage of applied insulin,clinical diagnosis and the changes of related biochemical criterion when the blood sugar in type 2 diabetic patients hospitalized was under control,based on different intensive insulin regimen and the intensive therapeutic schedule of insulin. METHODS 312 cases of the clinical diagnosis,the related biochemical test results and the clinical medical uses in type 2 diabetic patients hospitalized from 2012 to 2014 were analyzed retrospectively. Cluster Analysis was performed by using SPSS 19.0 and the results was analysed furtherly with the clinical diagnosis and the changes in biochemical indexes. RESULTS The clinical diagnosis and the biochemical indexes were clustered tinto 9 groups. The relevant analysis showed that the differences with the insulin per body weight,glycosylated hemoglobin,body max index（ BMI） and fasting C-peptide,were statistically significant（ P0.05）. Insulin per body weight and glycosylated hemoglobin was positively correlated with BMI,fasting C-peptide was negatively correlated. Dose analysis of different foundation,intensive insulin regimen showed that the basal insulin applied dose of 0.189±0.105 U·kg^-1and the intensive insulin dose of 0.622± 0.183 U·kg^-1. Variance analysis revealed that the differences of insulin dose are no statistically significant（ P0.05）. CONCLUSION The does of applied insulin,is closely related to clinical diagnosis and changes in biochemical indexes.