文章摘要
王紫晨1 冯明1 李耘1 钱玉英1 鲁梅花2 马雅辉2.门冬胰岛素与人普通胰岛素及胰岛素泵在2 型糖尿病患者围手术期 的疗效比较[J].,2011,11(19):3738-3741
门冬胰岛素与人普通胰岛素及胰岛素泵在2 型糖尿病患者围手术期 的疗效比较
Comparison Between Infusion Use of Insulin Aspart and Novolin R duringPerioperative Period of Patients with Type2 Diabetes Mellitus
  
DOI:
中文关键词: 2 型糖尿病  胰岛素泵  门冬胰岛素  围手术期
英文关键词: Type 2 diabetes mellitus  Continuous subcutaneous insulin infusion pump  Aspart  Perioperative
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作者单位
王紫晨1 冯明1 李耘1 钱玉英1 鲁梅花2 马雅辉2 首都医科大学宣武医院综合科 
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中文摘要:
      目的:探讨速效胰岛素类似物(门冬胰岛素,诺和锐)与人普通胰岛素(诺和灵R)及胰岛素泵在2 型糖尿病(T2DM)围手术期 治疗中的有效性和安全性。方法:158 例围手术期T2DM 患者随机分为胰岛素泵输注门冬胰岛素治疗CSII 组52 例,门冬胰岛素 多次皮下注射治疗MSII(A)组56 例,人普通胰岛素多次皮下注射治疗MSII(B)组50 例。观察各组患者治疗前后空腹和餐后2h 血 糖变化、血糖达标时间、胰岛素用量、低血糖发生率及术后并发症发生率。结果:3 组治疗后血糖均明显低于治疗前,CSII 组治疗后 血糖低于MSII(A)组(P<0.05),MSII(A)组治疗后血糖低于MSII(B)组(P<0.05);术后并发症CSII 组低于MSII(A)组(P<0.05),MSII (A)组低于MSII(B)组(P<0.05)。结论:门冬胰岛素对T2DM 围手术期血糖控制有较好的有效性、安全性和顺应性,胰岛素泵是2 型 糖尿病患者围手术期胰岛素输注的最佳模式。
英文摘要:
      Objective: To compare the efficacy and safety of rapid-acting human insulin analogue (Aspart) and regular human insulin (Novolin R) delivered with continuous subcutaneous insulin infusion (CSII) pump and multiple subcutaneous insulin infusion (MSII) on perioperative period of patients with type 2 diabetes mellitus. Methods: l58 perioperative patients with poorly-controlled type 2 diabetes in hospital were randomized to Group CSII (n=52,treated with insulin Aspart), Group MSII(A) (n=56,treated with insulin Aspart) and Group MSII(B) (n=50,treated with insulin Novolin R). AIl patients were treated to achieve target glycaemic control. The blood glucose, the time and the dose of insulin needed for good glycaemia control were compared of the three groups, the complications of surgery and incidence of hypoglycemia were evaluated too. Results: The levels of blood glucose in all groups were reduced after the treatments. The time for good glycaemia control was shorter in Group CSII than that in Group MSII(A) and Group MSII(B) (P<0.05). The mean of the postprandial blood glucose was significantly lower in Group CSII than that in Group MSII(A) and Group MSII(B) (P<0.01). The complications of surgery and incidence of hypoglycemia were significantly lower in Group CSII than that in Group MSII(A) and Group MSII (B) (P<0.05). Conclusion: For the perioperative period of patients with type 2 diabetes mellitus, insulin Aspart provides a more effective and safety control of blood glucose, it can control the hyperglycemia rapidly with lower fluctuations of blood glucose than Novolin R. The insulin pump could be the best mode of insulin infusion for perioperative type 2 diabetes.
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