不同时机皮下注射速效胰岛素类似物对高血糖危象患者血糖水平及MCP-1水平影响

目的 探讨不同时机皮下注射速效胰岛素类似物对高血糖危象患者血糖水平、MCP-1等指标的影响.方法 选取华北理工大学附属开滦总医院2017年3月至2018年11月89例高血糖危象患者应用微量泵持续注射胰岛素治疗,随机分为观察组(n=45,停止微量泵注射胰岛素后皮下注射胰岛素类似物)和对照组(n=44,在停止微量泵注射胰岛...

Effects of Subcutaneous Injection of Quick Acting Insulin Analogues at Different Time Points on Blood Glucose Level and MCP-1 Level in Patients with Hyperglycemic Crisis

  Objective  To investigate the effects of subcutaneous injection of quick acting insulin analogues on blood glucose level and MCP-1 in patients with hyperglycemic crisis.   Methods  A total of 89 patients with hyperglycemia crisis in our hospital from March 2017 to November 2018 were randomly divided into observation group （n = 45, subcutaneous injection of insulin analogue after insulin injection with micropump stopped） and control group （n = 44, insulin analogues were administered subcutaneously 1 hour before the insulin micropump was discontinued）. The mean blood glucose values and blood glucose fluctuation amplitude of patients in the two groups were measured at 0.5 and 1 h before pump withdrawal and 0.5, 1 and 2 h after pump withdrawal. White blood cell index （WBC）, urine ketone body, monocyte chemochemic protein-1 （MCP-1）, insulin resistance index （HOMA-IR）, osmotic pressure and anionic gap were detected in 2 groups > 24 h, and the changes of patients status were analyzed.  Results  There was no significant difference in blood glucose fluctuation between 2 groups at 0.5 h before pump stop, 0.5, 1 and 2 h after pump stop （P > 0.05）. There were no differences in homA-IR, WBC, MCP-1, urine ketone body, osmotic pressure and anionic gap between 2 groups before and after insulin analogue injection at different time points for 24 h （P > 0.05）.  Conclusion  For patients with hyperglycemic crisis, the conversion of subcutaneous insulin injection can be carried out simultaneously when the intravenous pump injection of insulin is stopped, and there is no effect on the blood glucose fluctuation, HOMA-IR, MCP-1, urinary ketone body, WBC, osmotic pressure and anion gap indexes 24 hours before and after injection.