糖尿病酮症酸中毒急诊采用胰岛素泵治疗对血酮体转阴时间的影响

Effect of Insulin Pump Therapy on Blood Ketone Body Negative Conver⁃sion Time in Emergency Treatment of Diabetic Ketoacidosis

目的探究胰岛素泵治疗糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)的效果。方法回顾性选取2023年4月—2024年3月福建医科大学附属龙岩第一医院急诊科收治的68例DKA患者的临床资料,依据治疗方案不同分为对照组(n=34,予以静脉滴注胰岛素治疗)、观察组(n=34,予以胰岛素泵治疗)。比较两组临床相关指标(血糖达标时间、尿酮体转阴时间、血酮体转阴时间、平均胰岛素用量)、血糖指标(空腹血糖、餐后2 h血糖)、炎症因子及氧化应激指标(白细胞介素-6、超氧化物歧化酶、谷胱甘肽过氧化物酶、超敏C反应蛋白)、酸中毒指标(二氧化碳结合力、血乳酸、β-羟丁酸)。结果与对照组相比,观察组血糖达标时间、尿酮体转阴时间、血酮体转阴时间均更短,平均胰岛素用量更少,差异有统计学意义(P均<0.05)。治疗后,观察组空腹血糖、餐后2 h血糖水平均低于对照组,差异有统计学意义(P均<0.05)。治疗后,研究组炎症及氧化应激水平、酸中毒指标均优于对照组,差异有统计学意义(P均<0.05)。结论DKA急诊采用胰岛素泵治疗,能够明显缩短血糖达标、尿酮体转阴和血酮体转阴时间,同时也可显著改善血糖、炎症及氧化应激水平以及酸中毒指标。

Objective To explore the effect of insulin pump in the treatment of diabetic ketoacidosis(DKA).Methods The clinical data of 68 patients with DKA admitted to the Department of Emergency of Longyan First Hospital Affiliated to Fujian Medical University from April 2023 to March 2024 were retrospectively selected.According to different treatment plans,they were divided into control group(n=34,intravenous infusion of insulin)and observation group(n=34,insulin pump treatment).The clinical indicators(blood glucose compliance time,urine ketone body negative conversion time,blood ketone body negative conversion time,average insulin dosage),blood glucose indicators(fasting blood glucose,2-hour postprandial blood glucose),inflammatory factors and oxidative stress indicators(interleukin-6,superoxide dismutase,glutathione peroxidase,hypersensitive C-reactive protein),acidosis indicators(carbon dioxide binding capacity,blood lactic acid,β-hydroxybutyric acid)were compared between the two groups.Results Compared with the control group,the time of blood glucose reaching the standard,the blood glucose compliance time,urine ketone body negative conversion time,blood ketone body negative conversion time in the observation group were shorter,and the average insulin dosage was less,the differences were statistically significant(all P<0.05).After treatment,the levels of fasting blood glucose and 2-hour postprandial blood glucose in the observation group were lower than those in the control group,and the differences were statistically significant(both P<0.05).After treatment,the levels of inflammation,oxidative stress and acidosis in the study group were better than those in the control group,and the differences were statistically significant(all P<0.05).Conclusion DKA emergency treatment with insulin pump can significantly shorten the time of blood glucose compliance,urine ketone body negative conversion and blood ketone body negative conversion,and can also significantly improve blood glucose,inflammation and oxidative stress levels and acidosis indicators.