1例2型糖尿病合并甲状腺相关性眼病患者激素冲击治疗的用药分析及药学监护

Medication analysis and pharmaceutical monitoring of hormone pulse therapy in a case of type 2 diabetes mellitus complicated with thyroid-associated ophthalmopathy

糖皮质激素对于胰岛素具有拮抗作用,使得激素冲击治疗的糖尿病患者的血糖变化更为复杂,本研究介绍了临床1例合并2型糖尿病的甲状腺相关性眼病(GO)患者在行甲泼尼龙冲击治疗期间的药物治疗及药学监护。提示GO患者硒制剂补充的必要性应按照眼部质量评分结果决定,且注意剂量和疗程的把握。同时,2型糖尿病患者行激素冲击治疗期间的降糖治疗是难点,应注意密切监测患者的血糖变化,及时预防激素作用带来的血糖峰值变化,同时监护后续的延迟效应可能造成的血糖升高结果,防范高血糖风险。

Glucocorticoid has an antagonistic effect on insulin,which makes the changes of blood glucose in diabetic patients treated with hormone pulse therapy more complicated.The drug treatment and pharmaceutical monitoring of a clinical case of thyroid-associated ophthalmopathy(GO)complicated with type 2 diabetes mellitus(T2DM)during methylprednisolone pulse therapy are introduced in this paper.It is suggested that the necessity of selenium supplement for GO patients should be determined according to the results of eye quality score,and attention should be paid to the control of dosage and course of treatment.At the same time,it is difficult for patients with T2DM to take hypoglycemic therapy during hormone pulse therapy.The changes of patients'blood glucose should be closely monitored,so as to prevent the peak changes of blood glucose caused by hormone action in time.And at the same time,the results of blood glucose rise that may be caused by the subsequent delayed effect are monitored to prevent the risk of hyperglycemia.