期刊文献+

胰岛素不同给药方式治疗2型糖尿病合并社区获得性肺炎研究 被引量:1

Research of Different Insulin Dosage Way in Treatment of Type-2 Diabetic Patients with Community Acquired Pneumonia
原文传递
导出
摘要 目的观察应用双C和MSII治疗2型糖尿病(type 2 diabetes mellitus,T2DM)合并社区获得性肺炎(community acquired pneumonia,CAP)患者强化血糖控制的有效性和安全性。方法将2004年10月至2009年10月在我院住院的未使用过胰岛素治疗的T2DM合并CAP患者99例随机分为双C组(50例)和MSII组(49例),分别给予双C和MSII。双C是应用持续皮下胰岛素输注(CSII)结合动态血糖监测系统(CGMS)-即"双C"方案。MSII是每日多次皮下注射胰岛素(MSII)结合每日八次指尖血糖监测。两组患者应用胰岛素和抗生素治疗后,观察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。结果双C组和MSII组患者治疗后空腹血糖分别为(6.3±0.2)mmol/L和(6.8±1.2)mmol/L,餐后2h血糖分别为(8.7±0.4)mmol/L和(9.3±1.2)mmol/L,均能达标。治疗后双C组患者果糖胺(7.2±0.13)mmol/L与MSII组(9.0±0.11)mmol/L比较,差异有统计学意义(P<0.01)。双C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(4.2±1.8)d、(3.7±1.2)d、(4.7±1.8)d、(8.2±1.3)d、(8.3±1.1)d和(9.2±2.6)d,血糖达标时间为(3.7±0.6)d、肺炎控制时间(12.8±4.5)d、胰岛素用量(37.6±6.5)U/d及低血糖发生频率(0.6±0.4)次/例;MSII组分别为(6.2±1.7)d、(4.3±1.4)d、(8.4±2.5)d、(9.6±3.5)d、(9.6±3.4)d、(12.4±4.1)d、(7.2±1.2)d、(18.2±6.8)d、(57.2±10.3)U/d和(4.3±0.7)次/例,两组比较差异均有统计学意义(P<0.05)。结论在配合抗生素的前提下,"双C"方案治疗能及时、有效地控制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 evaluate the efficacy and safety of continuous subcutaneous insulin injection (DOUBLE C) and multiple insulin (MSII) in treatment of type 2 diabetic patients with community-acquired pneumonia (CAP). Methods During the period from October 2004 to October 2009, 99 type 2 diabetic patients with CAP in our hospital were divided into group "DOUBLE C"(50 cases) and group MSII (49 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 fructosamine(7.2±0.13)mmol/L reduced significantly, and the level of fasting C-peptide(6.5±0.4)μg/L in creased remarkably in group "DOUBLE C", compared with group MSII (9.0± 0.11)mmol/L, (4.2±0.6)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 "DOUBLE C"(P〈0.05), while the requirement of insulin and rates of hypoglycaemia were lower in group "DOUBLE C" (P〈0.01), there were statistical differences between group "DOUBLE C" and group MSII. Conclusion "DOUBLE C" 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 patients with CAP.
出处 《热带医学杂志》 CAS 2010年第4期417-419,441,共4页 Journal of Tropical Medicine
基金 广东省医学科研基金(No.A2009268) 广州市中医药中西医结合科研基金(No.2005A045)
关键词 2型糖尿病 社区获得性肺炎 胰岛素泵 动态血糖监测系统 diabetes mellitus, type 2 community acquired pneumonia insulin pump
  • 相关文献

参考文献7

二级参考文献42

  • 1张豫生,王惠,米晓森.13例医院感染败血症临床分析[J].中华医院感染学杂志,2005,15(1):49-50. 被引量:9
  • 2董伟贤,胡必杰,何礼贤.122例医院败血症病例对照危险因素研究[J].中华医院管理杂志,2001,17(2):101-103. 被引量:9
  • 3周健,喻明,马晓静,张锋,卢逢娣.2型糖尿病全天血糖水平与糖化血红蛋白血糖漂移幅度的相关性分析[J].中国实用内科杂志:临床前沿版,2006,26(5):763-766. 被引量:71
  • 4陈名道.波动性高血糖与糖尿病并发症[J].国际内分泌代谢杂志,2006,26(5):312-314. 被引量:96
  • 5罗国春,阎德文.糖尿病与无症状低血糖[J].国际内分泌代谢杂志,2006,26(6):397-399. 被引量:47
  • 6Ngeow YF,Suwanjutha S,Chantarojanasriri T,et al.An asian study on the prevalence of atypical respiratory pathogens in community-acquired pneumonia.Int J Infect Dis,2005,9:144-153.
  • 7Lepow ML,Balassanian N,Emmerich J,et al.Interrelationships of viral,mycoplasmal,and bacterial agents in uncomplicated pneumonia.Am Rev Respir Dis,1968,97:533-545.
  • 8Lim WS,Macfarlane JT,Boswell TC,et al.Study of community acquired pneumonia aetiology(SCAPA) in adults admitted to hospital:implications for management guidelines.Thorax,2001,56:296-301.
  • 9Niederman MS,Mandell LA,Anzueto A,et al.Guidelines for the management of adults with community-acquired pneumonia.Diagnosis,assessment of severity,antimicrobial therapy,and prevention.Am J Respir Crit Care Med,2001,163:1730-1754.
  • 10Heffelfinger JD,Dowell SF,Jorgensen JH,et al.Management of community-acquired pneumonia in the era of pneumococcal resistance:a report from the Drug-Resistant Streptococcus pneumoniae Therapeutic Working Group.Arch Intern Med,2000,160:1399-1408.

共引文献1895

同被引文献6

引证文献1

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部