摘要
目的：研究短期强化胰岛素治疗（SCIIT）对重症病人应激性高血糖的调控及临床结局的影响。方法：在排除糖尿病及其他直接影响糖代谢的疾病条件下，治疗组在纳入研究的前7d，严格控制血糖于4．4～6．1mmol／L，7d以后的血糖控制及其他处理均同对照组。对照组病人的血糖按常规控制在3．9～10mmol／L。结果：41例病人人选，30例进入研究。在强化胰岛素治疗停止后第8～14天内，治疗组平均血糖为（5．92±1．24）mmol／L，明显较对照组（9．22±2．51）mmol／L低，同血糖正常值等效，同期每天胰岛素用量也明显比对照组低；两组30d病死率无明显差异，但死亡风险倾向于对照组；治疗组低血糖发生例数多于对照组。结论：在危重症病人中，采用短期强化胰岛素治疗方案，能达到同强化胰岛素治疗方案相同或者相似的控制目的，减少了低血糖的发生率。
Objectives： This prospective, randomized and controlled clinical trial was designed to investigate the effect of short course intensive insulin therapy （SCIIT） on stress-induced hyperglycemia and outcomes in critically ill patient. Methods ： The diabetes or other illness which directly influenced blood glucose were excluded and the critically ill patients was maintained with normoglycemia （4.4-6.1 mmol/ L） in the first seven days by intensive insulin therapy. After the first seven days, these patients was treated like conventional insulin treatment group. Conventional insulin treatment group was maintained with blood glucose at a level between 3.9-10 mmol/L. Results ： Of 41 patients enrolled in the study, 30 patients were eligible for analysis. After intervention stopped , blood glucose level in intensive insulin treatment group （5.92 ± 1.24 mmol/L ） was lower than in conventional insulin treatment group （9.22 ± 2.51 mmol/L） . And in the same time, insulin consumptions in SCIIT group was lower than in conventional insulin treatment group. There was no significant difference in ICU mortality between two groups, although decreasing trend favored to treatment group. Conclusion： In critical ill patient, SCIIT can achieve similar blood glucose range when compared with the plan of IIT. The benefit of improving morbidity and mortality could be expected in large sample RCTs.
出处
《肠外与肠内营养》
CAS
2006年第5期299-301,304,共4页
Parenteral & Enteral Nutrition
关键词
短期强化胰岛素治疗
应激性高血糖
危重症病
Short course intensive insulin therapy
Stress-induced hyperglycemia
Critically ill
