持续皮下注射胰岛素在2型糖尿病合并感染患者中的应用

目的 探讨持续皮下注射胰岛素治疗2型糖尿病合并感染的临床疗效、安全性及患者对用药的依从性.方法 将100例糖尿病合并感染患者按入院先后分为胰岛素泵组（52例）和对照组（48例）,胰岛素泵组采用住院患者胰岛素泵持续皮下注射胰岛素,出院后用胰岛素笔注射.对照组采用常规每日多次皮下注射胰岛素治疗,观察并对比两组患者连续治疗7d后的临床疗效及用药依从性.结果 治疗7d后,胰岛素泵组患者的治愈率明显高于对照组（39.6％）,差异有统计学意义（x2 =4.815,P =0.028）,感染控制所需时间为（9.8±1.7）d,较对照组明显缩短（11.4±2.9）d,差异有统计学意义（t=3.331,P=0.001）.胰岛素泵组患者空腹血糖及餐后2h血糖平均值均明显低于对照组（P＜0.05）,血糖达稳定状态所需时间明显短于对照组,差异有统计学意义（3.1±0.8）d比（6.11.1）d;t=15.489,P=0.000].胰岛素泵组患者每日平均胰岛素用量明显少于对照组,差异有统计学意义（31.2±13.6）U/d比（37.8±15.3） U/d;t =2.283,P=0.025].胰岛素泵组住院时间平均明显短于对照组,差异有统计学意义（15.4±3.2）d比（17.5±4.7）d;t =2.591,P=0.010].胰岛素泵组低血糖不良事件发生率明显低于对照组,差异有统计学意义（11.5％比2±7.1％;x2=3.919,P=0.048）.胰岛素泵组用药依从性平均评分及用药依从性佳者所占比例均明显优于对照组,差异有统计学意义（P＜0.05）.结论 采用胰岛素泵持续皮下注射胰岛素治疗糖尿病合并感染,能迅速、安全、有效地控制血糖,避免低血糖不良事件的发生,且能在一定程度上提高感染的治疗效果,缩短住院时间,同时提高了患者出院后用药的依从性及生活质量,值得临床推广.

Application of continuous subcutaneous insulin infusion on patients with co-infection of type 2 diabetes

Objective To discuss clinical effect,safety and patients compliance with drugs of continuous subcutaneous insulin infusion to treat co-infection of type 2 diabetes.Methods 100 patients with coinfection of diabetes were divided into the insulin pump group （52 cases） and the control group （48 cases）according to their time of hospitalization.The insulin pump group used insulin pump infusion during hospitalization and insulin pen injection after discharge while the control group used subcutaneous insulin injection several times a day.Clinical effect and drug compliance 7 days after treatment were observed and compared between two groups.Results 7 days after treatment,the rate of cure was obviously higher in the insulin pump group （61.5%） than in the control group （39.6%） and the difference was statistically significant （x2 =4.815,P =0.028）,and the time needed for infection control was also shorter in the in the insulin pump group （9.8 ± 1.7） d than in the control group （11.4± 2.9） d and the difference was statistically significant （t =3.331,P =0.001）.FBG and average blood glucose 2 hours after meal were significantly lower in the insulin pump group than in the control group （P 〈 0.05）.The time for blood glucose to recovery was shorter in the insulin pump group （3.1 ± 0.8） d than in the control group （6.1± 1.1） d and the difference was statistically significant （t =15.489,P =0.000）.Average insulin usage per day was less in the insulin pump group than in the control group （31.2 ± 13.6） U/d vs （37.8 ± 15.3） U/d; t =2.283,P =0.025].Average days in hospital was shorter in the insulin pump group than in the control group （15.4 ± 3.2） d vs （17.5 ± 4.7） d; t =2.591,P =0.010].Incidence of adverse events was lower in the insulin pump group than in the control group （11.5% vs 27.1%,x2 =3.919,P =0.048）.Patients drug compliance was also significantly better in the insulin pump group than in the control group （P 〈 0.05）.Conclusions Continuous subcutaneous insulin infusion can control blood sugar quickly,safely and effectively,so as to avoid adverse events,improve treatment effect,shorten days in hospital as well as improve patients compliance and quality of life after discharge,which is worthy promoting.