胰岛素泵持续皮下注射胰岛素治疗糖尿病合并甲亢的临床疗效观察

Clinical observation of continuous subcutaneous insulin infusion in the treatment of diabetes mellitus complicated with hyperthyroidism

目的探讨和分析持续皮下注射胰岛素治疗糖尿病合并甲亢的疗效。方法研究选择2014年4月-2017年4月间在本院进行治疗的100例糖尿病合并甲亢患者当做研究对象,按其入院顺序分甲组、乙组,每组50例。甲组患者通过持续皮下注射胰岛素行治疗,乙组患者通过皮下多次注射胰岛素行治疗,评价甲乙两组患者的临床情况、血糖情况、不良反应情况。结果甲组患者的血糖达标时间(10.14±8.02)d、胰岛素治疗总剂量(42.33±10.35)U、治疗费用(3694.14±277.62)元均少于乙组患者[(20.85±9.21)d、(60.42±15.42)U、(5681.51±384.25)元],差异对比具有统计学意义(t=6.201、6.888、29.644,P=0.000)。治疗后,甲乙两组患者的空腹血糖、餐后2 h血糖、糖化血红蛋白等水平均少于治疗前,差异对比具有统计学意义(P<0.05)。治疗后,甲组患者的空腹血糖水平(6.11±1.42)mmol/L、餐后2 h血糖水平(10.91±1.71)mmol/L均少于乙组患者[(8.24±0.98)mmol/L、(12.31±0.87)mmol/L],差异对比具有统计学意义(t=8.730、5.160,P=0.000)。治疗后,甲乙两组患者的糖化血红蛋白水平间差异对比不存在统计学意义(P>0.05)。治疗前,甲乙两组患者的血糖情况间差异对比不存在统计学意义(P>0.05)。甲组患者不良反应的总发生率(2.0%)少于乙组患者(14.0%),差异对比具有统计学意义(P<0.05)。结论在糖尿病合并甲亢的治疗中,持续皮下注射胰岛素的应用效果确切,使患者血糖快速达标,且胰岛素剂量使用较少,有效改善了患者的血糖水平,且降低了不良反应发生的风险,值得推广。

Objective To investigate and analyze the effect of continuous subcutaneous insulin injection in the treatment of diabetes mellitus complicated with hyperthyroidism. Methods 100 cases of patients undergoing diabetes mellitus complicated with hyperthyroidism in our hospital from April 2014 to April 2017 were selected as research objects, with 50 cases in each group. Patients at group A were given by continuous subcutaneous insulin injection treatment, while patients at group B were treated by subcutaneous injection of insulin. Clinical evaluation, blood sugar level and adverse reactions between two groups were compared. Results At group A,the time when blood glucose became normal was（10.14 ± 8.02）d, and the total dose of given insulin was（42.33 ± 10.35）U, and the total cost of patients was（3694.14 ±277.62） yuan. All above data at group A were less than those at group B whose data were（20.85 ±9.21）d,（60.42 ± 15.42）U and（5681.51 ± 384.25） yuan respectively. And all above data had statistically significant differences（t=6.201, 6.888）,（29.644, P=0.000）. After treatment, fasting blood glucose level, postprandial 2-hour-blood glucose level and glycosylated hemoglobin level of two groups were less than those before treatment, and the difference was statistically significant（P 0.05）. After treatment, among patients of group A, fasting blood glucose level was（6.11 ±1.42）mmol/L, and postprandial blood glucose level was（10.91±1.71） mmol/L,which were all less than those among patients at group B whose data were（8.24±0.98） mmol/L,（12.31±0.87）mmol/L respectively, the difference was statistically significant（t=8.730 and 5.160, P=0.000）. After treatment, the difference of glycosylated hemoglobin levels between two groups was not statistically significant（P 0.05）. Before treatment, there was no statistical difference about the blood glucose levels between two groups（P 0.05）. The total incidence of adverse effects in group A（2%） was less than that in group B（14%）, the difference was statistically significant（P 0.05）. Conclusion In the treatment of diabetes mellitus complicated with hyperthyroidism, the application effect of continuous subcutaneous insulin injection is obvious, and it can make the blood glucose level to be standard quickly and insulin use was less. Patients＇ blood sugar level were corrected effectively, and the risk of adverse effects was reduced too. So it is worthy of promotion.