摘要
目的比较胰岛素泵持续皮下注射胰岛素（CSII）与多次皮下注射胰岛素（三餐前超短效胰岛素＋甘精胰岛素，MSII）对短病程的2型糖尿病（T2DM）患者治疗后的效果差异。方法52例短病程T2DM患者随机分为CSII（n=29）和MSII（n=23）两组，入院即开始强化降糖治疗，同时服用二甲双胍，疗程为2周，出院后随访1个月。结果CSII组血糖达标时间为（4．70±2．01）d，明显短于MSII组（6．90±1．50）d，两组之间差异有统计学意义（t=2．056，P〈0．05）。CSII组餐后2hC肽治疗前后分别为（4．24±0．25）、（6．29±0．56）ng／L，MSII组餐后2hC肽治疗前后分别为（3．20±0．11）、（7．33±0．41）ng／L，两组餐后2hC肽水平治疗后均较人院时明显增高（t值分别为2．018、2．436，P均〈0．05），但两组之间差异无统计学意义（t=0．985，P〉0．05）。CSII组19例（65．5％）完全脱离胰岛素治疗；MSII组9例（39．1％）完全脱离胰岛素治疗，两组差异有统计学意义（x2=5．11，P〈0．05）。结论两种强化降糖方案均可使血糖在短时间内达标、胰岛功能不同程度的恢复，但CSII较MSII起效更快，更加有利于短期内脱离胰岛素的治疗。
Objective To compare the effect of insulin pump continuous subcutaneous insulin （CSII） and multiple subcutaneous insulin （short-acting insulin before meals ＋ glargine, MSII） for the short duration of type 2 diabetes mellitus （T2DM） patients. Methods Fifty-two newly diagnosed T2DM patients were randomly divided into CSII（ n =29） and MSII（ n =23） group. Patients in CSI! group were given insulin pump continuous subcutaneous plus metformin. And patients in MSII group were given insulin by multiple subcutaneous insulin injection plus metformin. The treating periods was 2 weeks and followed up one month. Results The periods from point of insulin injection to blood glucose back to normal level in CSII group was （4. 70 ± 2. 01 ） d, shorter than that in MSII group （6. 90 ± 1.50） d, and the difference was significant （t = 2. 056 , P 〈 0. 05 ）. The levels of C peptide in two hours postprandial before and after treatment in CSII group were （4. 24 ±0. 25 ） ng/L, （6. 29 ± 0. 56） rig/L, and （3.20± 0. 11 ） ng/L and （7. 33 ± 0.41 ） ng/L respectively in MSII group. The levels of C pepfide in two hours postprandial after treatment were higher than that of before treatment in two groups （t = 2. 018,2. 436 respectively,P 〈 0. 05 ）, but there were no significant differences between two groups（ t = 0. 985, P 〉0.05 ）. Nineteen cases （65.5%） in CSII group were off insulin treatment in one month , and 9 cases （39. 1% ） in MSII group. There were significant differences in two groups（ x2 = 5.11 ,P 〈 0. 05 ）. Conclusion The two treatment plans can make the improvement in terms of glucose control. However, CSII plan showed more effective than MSII.
出处
《中国综合临床》
2013年第12期1237-1239,共3页
Clinical Medicine of China
基金
黑龙江省卫生厅科研课题（20J1-661）
关键词
2型糖尿病
胰岛素
胰岛素泵
强化治疗
Type -2 diabetes mellitus
Insulin
Insulin pump
Intensive treatment
