摘要
目的:了解1型糖尿病住院患者的降糖治疗方案,为临床合理用药提供参考。方法:收集2010年1月—2016年12月常州市第一人民医院内分泌科379例1型糖尿病住院患者的病历资料,对患者的姓名、性别、出院日期、胰岛素及其他口服降糖药使用情况等信息进行统计分析。结果:379例患者中,7例患者中途转院无法统计相关信息,其余372例患者入院期间均使用胰岛素治疗。372例患者的胰岛素治疗方案分为5种,分别为持续皮下胰岛素输注(胰岛素泵治疗)、基础联合餐时胰岛素替代治疗、每日多次预混胰岛素注射、单用基础长效胰岛素及单用餐时速效胰岛素,其中,持续皮下胰岛素输注(46例,12.37%)和基础联合餐时胰岛素(301例,占80.91%)的治疗方案因能更好地模拟人体生理胰岛素的分泌模式而被较多使用;少数患者(17例,占4.57%)采用每日多次预混胰岛素注射;个别患者因自身血糖特点或依从性问题,采用单独使用基础长效胰岛素或单独使用餐时速效胰岛素治疗。150例患者采用胰岛素注射与口服降糖药联合应用的降糖治疗方案,其中二甲双胍(90例,使用率为60.00%)、阿卡波糖(85例,使用率为56.67%)与胰岛素的联合应用较多。结论:1型糖尿病患者因自身胰岛素绝对缺乏多终身使用胰岛素替代治疗。此外,临床有一定数量的1型糖尿病患者除使用胰岛素治疗外,还使用口服降糖药如二甲双胍、阿卡波糖等控制血糖,对该部分患者的用药监护有别于2型糖尿病,应给予重视。
OBJECTIVE： To investigate the hypoglycemic therapy regimen of inpatients with type Ⅰ diabetes, so as to provide references for clinical rational medication. METHODS ： Case data of 379 inpatients with type I diabetes in department of endocrinology in the First People＇s Hospital of Changzhou from Jan. 2010 to Dec. 2016 were collected and analyzed in terms of patients＇ names, genders, date of discharge from hospital, application of insulin and other oral hypoglycemic agents. RESULTS ： Of the 379 cases, 7 patients were transferred to other hospitals halfway, all the rest 372 patients were given insulin during hospital stays. There were 5 therapeutic regimens of insulin treatment, respectively were continuous subcutaneous insulin infusion （insulin pump ）, conventional therapy combined with mealtime insulin replacement therapy, repeatedly pre-mixed insulin injection, single medication of long-acting insulin and single medication of quick-acting insulin, of which continuous subcutaneous insulin infusion （46 cases, 12. 37% ） and conventional therapy combined with mealtime insulin replacement therapy （301 cases, 80. 91% ） were the mostly used regimens because they can simulate the secretion of physiological insulin better; a small number of patients （17 cases, 4.57% ） were treated with repeatedly pre-mixed insulin injection; few patients were given single medication of long-acting insulin or single medication of quick-acting insulin for individual features of blood glucose and compliance. Among the 150 cases of patients with combined application of insulin for injection and oral hypoglycemic agents,metformin （90 cases, 60.00% ） （85 cases, 56.67% ）were the mostly used. CONCLUSIONS： Due to the definite deficit of insulin, most patients with type Ⅰ diabetes were treated with insulin replacement lifetime. Besides, a certain number of patients with type Ⅰ diabetes were also given oral hypoglycemic metformin and aearbose except for insulin, medication monitoring on these patients is different from that Ⅱ diabetes, which needs to be paid attention.
作者
张琪
孙婷婷
王龙
石欢
胡楠
ZHANG Qi;SUN Tingting;WANG Long;SHI Huan;HU Nan(Dept. of Pharmacy, the First People＇s Hospital of Changzhou, Jiangsu Changzhou 213003, China;Dept. ot Pharmacy, t~nangznou No. 7 People＇s Hospital, Jiangsu Changzhou 213003, China;Dept. of Pharmacy, Kangda College of Nanjing Medieal University, Jiangsu Lianyungang 222006, China;Dept. of Endocrinology, the First People＇s Hospital of Changzhou, Jiangsu Changzhou 213003, China)
出处
《中国医院用药评价与分析》
2018年第4期529-533,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
国家自然科学基金资助项目(No.81503136)
关键词
Ⅰ型糖尿病
降糖治疗方案
胰岛素
口服降糖药
用药监护
超说明书用药
Type Ⅰ diabetes
Hypoglycemic therapy regimen
Insulin
0ral hypoglycemic agents
Administrationmonitoring
0ff-label medication
