老年危重病患者应激性高血糖的强化胰岛素治疗

目的探讨早期强化胰岛素治疗老年危重病患者应激性高血糖的临床疗效。方法采用前瞻,随机,对照临床试验,将72例老年(>65岁)危重病患者分为常规组(n=36)和胰岛素强化治疗组(n=36)。常规治疗是指当患者血糖≥12·0mmol/L时,控制其血糖水平<12mmol/L;强化治疗组则控制患者血糖水平4～10mmol/L,直到患者转出ICU或死亡,两组其余临床治疗相同。分析两组病例预后指标之间的差异性。结果两组存活病例住ICU时间、感染发生率、病死率方面差异有统计学意义(P<0·05)。结论对于发生应激性高血糖的老年危重病患者,早期强化胰岛素治疗能更有效、更及时控制血糖,并显著改善临床疗效。

Intensive insulin therapy for critical old patients with stress hyperglycemia

Objective To observe the clinical curative effect of early intensive insulin therapy for critical old patients with stress hyperglycemia Methods We performed a prospective,randomized,controlled study involved in the critical old patients.72 patients were randomly assigned to treatment group or control group Treatment group（36 cases） received intensive insulin therapy,the blood glucose levels were preserved 4~10 mmol/L The control group（36 cases） received routine insulin therapy,the blood glucose levels were maintained under 12 mmol/L The hours in ICU,the incidence rate of infection,mortality were recorded Results The hours in ICU,the incidence rate of infection,mortality were decreased significantly in the treatment group than those in the control group（P0.05） Conclusion For critical old patients with stress hyperglycemia,early intensive insulin therapy can control blood glucose more effectively and promptly and improve the clinical curative effect.