期刊文献+

糖尿病腹膜透析患者胰岛素治疗方案探讨 被引量:9

Insulin therapy in diabetic peritoneal dialysis patients
下载PDF
导出
摘要 目的 探讨糖尿病腹膜透析 (CAPD)患者合理的胰岛素应用方法。方法 采用横断面研究方法调查所有接受CAPD治疗至少 6个月以上的糖尿病肾病患者的胰岛素使用方案及血糖控制情况。并在横断面研究的基础上 ,动态观察 2 4例新收的糖尿病CAPD患者透析前、后胰岛素的使用方法、剂量调整方案及血糖控制情况。结果  2 0 0 2年 6月至 2 0 0 2年 12月间共 2 5例 2型糖尿病CAPD患者 ,其中腹腔内注射胰岛素 (IP) 6人 ,皮下注射胰岛素 (SC) 9人 ,腹腔和皮下联合应用 (IP +SC) 7人。①空腹血糖、糖化血红蛋白、透析液糖总负荷量、透析液平均糖浓度、透析剂量在IP、SC、IP +SC三组间差异均无显著性 ,(P >0 .0 5 ) ;②与IP及IP +SC组相比 ,SC组胰岛素用量明显减少 ,(P <0 .0 5 ) ;③腹膜炎的总发生率为 1次 /每 15患者月 ,明显高于同期非糖尿病腹膜透析患者的腹膜炎发生率 (1次 /每 4 8患者月 ) ,(P <0 .0 1) ;④动态观察 2 4例新收的糖尿病CAPD患者 ,胰岛素剂量较透析前平均增加了 (0 .33± 0 .2 3)倍。透析后调整的胰岛素实际增加量与理论预测增加量差异无显著性 ,(P >0 .0 5 )。患者血糖控制良好 ,平均为(5 .81± 1.2 2 )mmol/L。结论 皮下注射胰岛素是有效控制糖尿病CAPD患者血糖水平的适当途径。腹膜透析后 。 Objective To study the optimal insulin therapy in diabetic peritoneal dialysis patients. Methods In a cross-sectional study, 25 type 2 diabetic patients treated with peritoneal dialysis for at least 6 months were investigated. We reviewed their dialysis prescription, insulin therapy regimen and blood glucose control. We also retrospectively studied the changes of insulin doses and glycemic control in 24 new diabetic peritoneal dialysis patients. Results In the cross-sectional study, 23 of the 25 patients used insulin, 6 cases by intraperitoneally(IP), 9 cases by subcutaneously(SC), and 7 cases via the combined subcutaneous and intraperitoneal routes(IP+SC). There were no significant differences in the fasting blood glucose, glycosylated hemoglobin, dialysate glucose concentrations, dialysate glucose load, dialysate doses among the three groups, whereas the insulin doses was significantly reduced in SC group as compared with the IP and IP+SC group (P<0.05). The peritonitis rate was higher in diabetics patients (1/15 per patient month) as compared to nondiabetic patients (1/48 per patient month) (P<0.01). After starting peritoneal dialysis in the 24 new patients, the insulin dosage was increased(0.33±0.23) times as compared to pre-dialysis insulin dose. There were no differences between practical and theoretical increase in insulin doses (P>0.05). Conclusion Our data suggest that subcutaneous insulin administration in peritoneal dialysis patients is more economic and convenience and is effective in blood glucose control.
出处 《中国血液净化》 2004年第5期243-246,共4页 Chinese Journal of Blood Purification
基金 中华人民共和国教育部长江学者奖励计划 教育部振兴行动计划专项基金 (985工程 )资助
关键词 糖尿病 腹膜透析 胰岛素 CAPD 血糖 Peritoneal dialysis Diabetics Insulin
  • 引文网络
  • 相关文献

参考文献7

  • 1[1]Lino S, Sergio B, Roberto S, et al. Peritoneal dialysis in diabetics. Optimal insulin therapy on CAPD: intrapetitoneal versus subcutaneous treatment. Petit Dial Int, 1996, 16 (suppl 1): S275- 278 被引量:1
  • 2[2]Ponikvar R, Buturovic Ponikvar J. Management of diabetic patients with hecmedialysis, peritoneal dialysis, and renal transplantation. Nephrol Dial Transplant, 2001, 16 (suppl 6) :94 - 96 被引量:1
  • 3[3]Yu CC, Wu MS, Wu CH,et al. Predialysis glycemic control is an independent predictor of clinical outcome in type Ⅱ diabetics on continuous ambulatory peritoneal dialysis. Petit Dial Int, 1997, 17(3) :262 - 268 被引量:1
  • 4[4]Ednard Q. Advisability of switching of IP insulin in to CAPD. Seminars in dialysis, 2002, 15(5) :376 被引量:1
  • 5[5]Anseri A, MB, BS, et al. Assessing glycemic control in patients with diabetes and end- stage renal failure. Am J Kidney Dis, 2003, 14(3):523 - 531 被引量:1
  • 6[6]Misrs M. and Nolph K (2000). Peritoneal dialysis in diabetic endstage renal disease. In: Gokal R. Khanna R. Krediet R and Nolph K (eds). Textbook of peritoneal dilaysis. Dordrecht, Kluwer Academic Publishers, 2000, 647 - 666 被引量:1
  • 7[7]Wang T, Heimburger O, Waniewski J, et al. Increased peritoneal permeability is associated with decreased fluid and small solute removal and higher mortality in CAPD patients. Nephrol Dial Transplant, 1998, 13:1242- 1249 被引量:1

同被引文献40

引证文献9

二级引证文献23

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