摘要
目的观察应用胰岛素泵进行连续皮下胰岛素输注(CSII)与常规胰岛素注射(MSII)治疗老年2型糖尿病(T2DM)合并社区获得性肺炎(CAP)患者强化血糖控制的有效性和安全性。方法将2004年1月—2008年1月在我院住院的未使用过胰岛素治疗的老年T2DM合并CAP患者78例随机分为两组:CSII组(39例)和MSII组(39例),分别给予CSII和MSII。观察两组患者应用胰岛素和抗生素治疗后,CAP主要症状缓解时间、血糖达标时间、胰岛素用量、低血糖发生频率及肺炎控制时间的差异。结果CSII组和MSII组患者治疗后空腹血糖〔分别为(6.5±0.3)mmol/L和(6.6±0.4)mmol/L〕和餐后2h血糖〔分别为(8.9±0.6)mmol/L和(8.9±0.5)mmol/L〕均能达标。治疗后CSII组患者空腹C肽、糖化血红蛋白和C-反应蛋白水平〔分别为(6.2±0.5)μg/L、(7.0±2.1)%和(14.3±6.1)mg/L〕与MSII组〔分别为(4.0±0.7)μg/L、(8.9±1.8)%和(22.0±8.0)mg/L〕比较,差异均有统计学意义(P<0.01)。CSII组患者肺炎主要症状(发热、胸痛、咳黄痰、剧烈咳嗽、呼吸困难和湿啰音)缓解时间〔分别为(4.1±2.0)d、(3.8±1.1)d、(4.5±1.9)d、(7.8±2.6)d、(8.1±1.4)d和(9.0±2.8)d〕、血糖达标时间〔(3.8±0.8)d〕、肺炎控制时间〔(13.1±5.4)d〕、胰岛素用量〔(38.5±7.5)U/d〕及低血糖发生频率〔(0.7±0.3)次/例〕与MSII组〔分别为(6.0±1.8)d、(4.4±1.2)d、(8.2±2.4)d、(10.4±3.9)d、(9.5±2.4)d、(12.1±3.7)d、(6.3±1.1)d、(17.6±7.4)d、(47.7±11.4)U/d和(3.4±0.8)次/例〕比较,差异均有统计学意义(P<0.05)。结论CSII配合抗生素治疗能及时、有效地控制老年T2DM合并CAP患者的血糖水平,肺炎症状缓解时间及治愈肺炎的时间均较MSⅡ组短,而且胰岛素用量少,低血糖发生率低,是理想的治疗方法。
Objective To study the efficacy and safety of continuous subcutaneous insulin injection(CSII) and multiple insulin(MSII) in treatment of type 2 diabetic elderly patients with community-acquired pneumonia(CAP).Methods During the period from January 2004 to January 2008,78 type 2 diabetic elderly patients with CAP in our hospital were divided into group CSII(39 cases) and group MSII(39 cases) at randomly,these patients has never used insulin before,to observe the days of controling all symptoms of pneumonia,blood glucose up to scratch and cure of pneumonia,the requirement of insulin,rates of hypoglycaemia between the two groups after insulin and antibiotics therapy.Results Blood glucose levels of all patients in two groups were up to standards.After the treatment,the levels of glycated hemoglobin〔(7.0±2.1)%〕 and C-reactive protein〔(14.3±6.1)mg/L〕 reduced significantly,and the level of fasting C-peptide〔(6.2±0.5)μg/L〕 increased remarkably in group CSII,compared with group MSII〔(8.9±1.8)%,(22.0±8.0)mg/L,(4.0±0.7)μg/L,respectively〕(P<0.01).The days of controling all symptoms of pneumonia,blood glucose up to scratch and cure of pneumonia were significantly shorter in group CSII(P<0.05),while the requirement of insulin and rates of hypoglycaemia were lower in group CSII(P<0.01),there were statistical differences between group CSII and group MSII.Conclusion CSII in conjugation with antibiotics is able to control blood glucose,all symptoms of pneumonia and days of cure of pneumonia in time and effectually.The method has low expenditure of insulin and rates of hypoglycaemia,which is a better method for type 2 diabetic elderly patients with CAP.
出处
《中国全科医学》
CAS
CSCD
北大核心
2009年第12期1039-1042,共4页
Chinese General Practice
关键词
糖尿病
2型
社区获得性肺炎
胰岛素泵
老年人
Diabetes mellitus,type 2
Community acquired pneumonia
Insulin pump
Aged
