持续皮下胰岛素注射治疗42例老年女性糖尿病合并心力衰竭的临床效果

目的：考察持续皮下胰岛素注射治疗对于老年女性糖尿病合并心力衰竭的治疗效果。方法选取2010年1月至2011年12月平湖市第一和第二人民医院就诊的老年女性糖尿病合并心力衰竭患者42例，随机分为对照组（22例）和研究组（20例），两组患者均接受常规心力衰竭治疗，对照组采用多次皮下注射胰岛素治疗，研究组采用持续皮下胰岛素注射治疗。治疗8周后，考察患者治疗效果和心脏超声心动图情况（左室射血分数、舒张期内径、左室舒张末期容积指数和收缩末期容积指数），随访患者15个月内不良反应（再次入院率、低血糖事件和血糖变异系数）。结果对照组患者治疗总有效率为90．1％，研究组总有效率70．0％，两组患者总有效率比较具有显著性差异（u＝2．61，P＜0．01）；不良反应中，研究者低血糖事件显著低于对照组（χ2＝16．00，P＜0．01），再次入院率、血糖变异系数研究组优于对照组（χ2＝4．27，P＜0．05；t＝5．36，P＜0．05）；两组治疗后比较，研究组LVEF低于对照组（t＝2．213，P＜0．05），LVEDD和LVEDVI高于对照组（t＝2．342，P＜0．05；t＝2．089，P＜0．05）。结论持续皮下胰岛素注射治疗老年女性糖尿病合并心力衰竭能够明显改善患者心功能，而且不良反应少，具有更好的治疗效果。

Therapeutic effect of CSII treatment on 42 elderly female patients with DM and congestive heart failure

Objective To investigate the therapeutic effect of continuous subcutaneous insulin injection （ CSII） treatment on elderly female patients with diabetic mellitus （ DM ） and congestive heart failure .Methods Forty-two elderly female patients with DM combined with congestive heart failure were selected from January 2010 to December 2011 in Pinghu First People ’ s Hospital and Pinghu Second People ’ s Hospital .They were randomly assigned to control group （ 22 cases ） and treatment group （ 20 cases ） , and both groups received conventional treatment for heart failure .The control group received multiple subcutaneous insulin therapy , while the treatment group received CSII therapy.After treatment for 8 weeks, the therapeutic effect, echocardiography （LVEF, LVEDD, LVEDVI and LVESVI） and adverse reactions within 15 months （ readmission rate , low blood sugar events and coefficient of variation ） were investigated .Results The total efficiency of the control group was 70.0%, and that of the treatment group was 90.1%.The difference between them was statistically significant （U=2.61,P〈0.01）.In adverse reactions, hypoglycemic events were significantly fewer in the treatment group （χ2 =16.00,P〈0.01）.Re-admission rate and blood glucose coefficient in the treatment group were better than the control group （χ2 =4.27,P〈0.05;t=5.36, P〈0.05）.After treatment LVEF was less in the treatment group （t=2.213,P〈0.05）, but LVEDD and LVEDVI were higher （t value was 2.342 and 2.089, respectively, both P〈0.05）.Conclusion CSII therapy in elderly women with DM and heart failure can improve cardiac function with fewer adverse reactions and better therapeutic effect .