基于超声精准检测下胰岛素注射致皮下脂肪增生的影响因素分析

Influencing factors of subcutaneous lipohypertrophy induced by insulin injection based on ultrasound examination

目的基于超声检测结果,分析Ins注射皮下脂肪增生(LH)发生的影响因素。方法纳入2017年1月至2018年1月于我院内分泌科接受Ins治疗的142例DM患者,采用自行设计问卷收集患者性别、年龄、受教育程度、BMI、家庭月收入、DM病程、Ins注射等资料。应用视触诊、超声检查筛查LH发生情况,比较两种检查方法检出率;将经超声检出LH患者103例纳入阳性组,未检出LH患者39例纳入阴性组,采用Logistic回归分析Ins导致LH的影响因素。结果经超声共检出103例患者Ins注射皮下LH,检出率高于视触诊(72.53%vs 45.07%,P<0.001)。阴性组与阳性组年龄、文化程度、BMI及是否正确轮换注射部位比较,差异有统计学意义(P<0.05);Logistic回归分析显示,是否正确轮换注射部位(OR 3.525,95%CI 1.410~8.811)是LH的独立危险因素。结论超声检查可能更准确识别Ins注射导致的LH;低龄、低文化程度、低BMI及未正确轮换注射部位更易发生LH。

Objective To explore the occurrence of subcutaneous lipohypertrophy induced by insulin injection and analyze its influencing factors based on ultrasonic examination.Methods 142 diabetic patients receiving insulin treatment were detected by visual and palpation examinations and ultrasound examination to identify lipohypertrophy.Monovariant and multivariant logistic regression were performed to analyze the influencing factors of lipohypertrophy induced by insulin injection.Results Compared with the visual and palpation examinations,ultrasound examination showed higher detection rate of subcutaneous lipohypertrophy(72.53%vs 45.07%,P<0.001).Monovariant analysis showed age(P=0.019),education level(P=0.031),body mass index(P=0.016)and rotation of injection site(P=0.002)were related to the occurrence of lipohypertrophy.Logistic regression analysis found that wrong rotation of injection site(OR 3.525,95%CI 1.410~8.811)was the risk factor of subcutaneous lipohypertrophy.Conclusion Ultrasonic examination can accurately identify subcutaneous lipohypertrophy induced by insulin injection.Diabetic patients with lower age,education level,BMI,and inappropriate rotation of injection sites are more likely to develop subcutaneous lipohypertrophy.