胰岛素持续皮下泵注治疗糖尿病合并冠心病疗效对照研究

Control study of continuous subcutaneous insulin injection in treating diabetes with coronary heart disease

目的探讨胰岛素持续皮下泵注治疗糖尿病合并冠心病患者的临床疗效。方法将90例糖尿病合并冠心病患者采用随机数字表法分为观察组与对照组，每组45例。观察组给予胰岛素持续皮下泵注治疗，对照组给予胰岛素多次皮下注射治疗，比较两组患者生化指标及血糖波动水平变化情况。结果治疗后两组体质量指数、糖化血红蛋白、空腹血糖、餐后2h血糖均较治疗前下降，但差异无统计学意义（P〉0．05）；两组胰岛素抵抗指数、血清内皮脂肪酶及超敏C反应蛋白水平均较治疗前显著下降（P〈0．01），观察组较对照组下降更显著（P〈0．01）；两组血糖波动水平较治疗前显著下降（P〈0．01），观察组较对照组下降更显著（P〈0．01）。结论胰岛素持续皮下泵注治疗糖尿病合并冠心病可以有效降低及控制患者血糖水平，还具有抗炎、抗勃脉粥样硬化及减少糖尿病相关并发症的效果。

Objective To investigate the clinic effect of continuous subcutaneous insulin injection in treating diabetes with coronary heart disease. Methods 90 cases with diabetes and coronary heart disease were selected and divided into observation group and control group according to random number table, 45 cases in each group. The observation group was treated with continuous subcutaneous insulin injection, the control group was treated with multiple subcutaneous insulin injection. Biochemical criterion, blood glucose fluctuation level changes of the two groups were compared. Results Body mass index, glycosylated hemoglobin, FBG, 2 hour postprandial blood glucose of the two groups after treatment were declined, the difference was not statistic significant （P〉0.05） ; insulin resistance index, serum endothelial lipase, hy- persensitive c-reactive protein level of the two groups after treatment were significantly declined （P 〈0. 01）, observation group declined more obviously than control group （P〈0. 01）; blood glucose fluctuation level of the two groups was significantly declined （P〈0.01）, observation group declined more obviously than control group （P〈0. 01）. Conclusion Continuous subcutaneous insulin administration on treatment of coronary heart disease with diabetes can effectively lower and control blood glucose level, it is anti-inflammatory, anti-atherosclerosis, and can lower related complications of diabetes.