摘要
目的 分析胰岛素泵、静脉滴注胰岛素分别联合静脉补液治疗糖尿病酮症酸中毒的效果.方法 将80例糖尿病酮症酸中毒患者用随机数字表法分为对照组和研究组,各40例.对照组予以小剂量胰岛素持续静脉滴注联合静脉补液治疗,研究组予以胰岛素泵皮下输注联合静脉补液治疗.比较2组血酮体转阴时间、血糖达标时间、尿酮体转阴时间、血浆pH恢复时间、胰岛素用量、低血糖发生率、临床疗效,比较2组治疗前后的氧化应激指标及炎症反应指标[超氧化物歧化酶(superoxide dismutase,SOD)、丙二醛(malondialdehyde,MDA)、谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-PX)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)]水平的变化.结果 治疗后,研究组的血酮体转阴时间、血糖达标时间、尿酮体转阴时间、血浆pH恢复时间较对照组均明显缩短(P<0.05);研究组的胰岛素用量、低血糖发生率均显著低于对照组(P<0.05);2组SOD、GSH-PX水平均升高,MDA水平均降低,且研究组SOD、GSH-PX水平均高于对照组,MDA水平低于对照组(P<0.05);2组的TNF-α、CRP、IL-6水平均下降,且研究组低于对照组(P<0.05);研究组的治疗总有效率高于对照组(92.50%vs.65.00%,P<0.05).结论 与小剂量胰岛素持续静脉滴注相比,胰岛素泵持续皮下输注联合静脉补液治疗糖尿病酮症酸中毒的疗效更显著,可减少胰岛素用量,降低低血糖发生率,且能在短时间内恢复血糖、pH值,缩短血酮体、尿酮体转阴时间,改善机体氧化应激状态,并减轻炎症反应.
Abstract
Objective To analyze the effect of insulin pump,insulin intravenous drip combined with intravenous fluid rehydration in the treatment of diabetic ketoacidosis.Methods 80 patients with diabetic ketoacidosis treated in our hospital were divided into control group and study group according to random number table method,40 cases in each group.The control group received continuous intravenous infusion of low-dose insulin combined with intravenous rehydration therapy,while the study group received subcutaneous insulin pump infusion combined with intravenous rehydration therapy.The time to negative blood ketone bodies,the time to reach the blood glucose standard,the time to negative urine ketone bodies,and the recovery time of plasma pH were compared.The insulin dosage,the incidence of hypoglycemia,the oxidative stress indexes and inflammatory response indexes[superoxide dismutase(SOD),malondialdehyde(MDA),glutathione peroxidase(GSH-PX),tumor necrosis factor alpha(TNF-α),C-reactive protein(CRP)and interleukin-6(IL-6)],and the clinical efficacy of the 2 groups before and after treatment were compared.Results After treatment,compared with the control group,the time of blood ketone body turning negative,blood glucose reaching the standard time,urine ketone body turning negative time,and plasma pH recovery time in study group were significantly shorter than those in control group(P<0.05);the insulin dosage and the incidence of hypoglycemia in study group were significantly lower(P<0.05);after treatment,the levels of superoxide dismutase(SOD)and glutathione peroxidase(GSH-PX)in the 2 groups were increased,and the levels of MDA were decreased.And the levels of SOD and GSH-PX in study group were higher than those in control group,and the level of MDA was lower than that in control group(P<0.05).After treatment,the serum levels of TNF-α,CRP,and IL-6 in the 2 groups decreased,and the study group was lower than the control group(P<0.05).The total effective rate of the study group was higher than that of the control group(92.50%vs.65.00%,P<0.05).Conclusion Compared with continuous intravenous infusion of low-dose insulin,continuous subcutaneous infusion of insulin pump combined with intravenous rehydration therapy has a more significant effect,which can reduce insulin dosage,reduce the incidence of hypoglycemia,and can be used to restore blood sugar and pH value in a short time,shorten the time of blood ketone body and urine ketone body turning negative,improve the oxidative stress state of the body,and reduce the inflammatory response safely.
维普
万方数据