比较胰岛素泵与多次胰岛素皮下注射强化治疗2型糖尿病合并脑卒中的临床价值

Comparation of clinical value between subcutaneous insulin pump and multiple subcutaneous insulin intensive treatment on type 2 diabetes combined with stroke

目的探究分析胰岛素泵(CSⅡ)与多次胰岛素皮下注射强化治疗(MDI)对2型糖尿病合并脑卒中患者的临床疗效。方法选择2011年4月至2014年5月来该院诊治的80例2型糖尿病合并脑卒中患者为研究对象,按照随机数字表法分为研究组和对照组,每组40例患者。研究组患者给予CSⅡ治疗,对照组患者给予MDI。比较2组患者治疗前后的血糖水平,血糖达标时间、低血糖次数、胰岛素用量、美国国立卫生研究院卒中量表(NIHSS)评分,以及胰岛素分泌指数(IS)、胰岛素抵抗指数(IR)、住院费用等。结果治疗前2组患者在早餐前后、午餐前后、晚餐前、晚餐后2h等时间点的血糖水平、血糖达标时间、低血糖次数、胰岛素用量、NIHSS评分、IS、IR指标差异均无统计学意义(P>0.05)。治疗后2组患者在这些时间点血糖水平、血糖达标时间、低血糖次数、胰岛素用量、NIHSS评分、IS、IR均明显降低,但研究组降低更为明显,2组差异有统计学意义(P<0.05)。研究组患者的住院费用明显低于对照组,差异有统计学意义(P<0.05)。结论 CSⅡ治疗2型糖尿病合并脑卒中患者,不仅能够很好地控制血糖水平,降低低血糖次数与胰岛素用量,明显改善IS与IR,减少住院费用,而且能够明显改善患者的神经功能意识障碍,是一种较MDI更理想的治疗方法。

Objective To explore the clinical value of the insulin pump(CSⅡ)and multiple subcutaneous insulin intensive treatment(MDI)for patients with type 2diabetes and stroke.Methods A total of 80 patients with type 2 diabetes and stroke in Weifang Community Health Service Center from April 2011 to May 2014 were selected as subjects and divided into experimental group and control group according to random number table method,with 40 cases in each group.Patients in the experimental group were treated with CSⅡ,patients in the control group were treated with MDI.Glucose level,therapeutic time,the number of low blood sugar,insulin dosage,National Institute of Health Stroke Scale(NIHSS)score,insulin secretion index(IS),insulin resistance index(IR),hospital costs were compared before and after treatment in the two groups.Results The glucose levels,therapeutic time,the number of low blood sugar,insulin dosage,NIHSS score,IS,IR in the two groups before and after breakfast,before and after lunch,before dinner,after dinner 2 hours before treatment had no significant differences(P>0.05),the glucose levels,therapeutic time,the number of low blood sugar,insulin dosage,NIHSS score,IS,IR after treatment in both groups were significantly decreased at these time points,but those indicators in the experimental group decreased more significantly,and had significant differences with those of the control group(P<0.05).The cost of hospitalization of patients in the experimental group was significant lower than that in the control group(P<0.05).Conclusion CSⅡtreatment for type 2 diabetes and stroke patients,not only control glucose level well,reduce the number of low blood glucose and insulin dosage,significantly improved IS and IR,reduce hospital costs,and also could significantly improve the neurological disorders of consciousness,which is an ideal treatment method compared with MDI.