2种胰岛素给药方案对2型糖尿病合并肺部感染的疗效比较

目的：比较胰岛素泵与多次皮下注射胰岛素治疗2型糖尿病合并肺部感染的临床疗效。方法选取2012年1月至2013年12月医院收治的2型糖尿病合并肺部感染患者102例，随机分为研究组55例和对照组47例。两组患者均给予消炎、吸氧、平喘、吸痰等对症支持治疗肺部感染研究组加用胰岛素泵进行治疗，对照组加用多次皮下注射胰岛素进行治疗。观察两组患者的肺部感染控制疗效，检测治疗前后的炎性因子水平、血糖控制情况以及胰岛素用量，记录不良反应。结果治疗后，研究组肺部感染控制总有效率为94.55%，明显高于对照组为87.23%（ P〈0.05）；研究组的炎性因子血清白细胞介素-6、白细胞介素-8、超敏C反应蛋白水平明显低于对照组（ P〈0.05）；研究组患者各时间段的血糖水平和胰岛素平均用量均低于对照组（ P〈0.05）；研究组发生低血糖5例（9.09%），对照组12例（25.53%），具有统计学差异（ P〈0.05），其余不良反应比较无统计学差异（ P＞0.05）。结论胰岛素泵治疗2型糖尿病合并肺部感染的临床疗效好，能显著降低患者的炎性因子水平，有效控制血糖水平，且胰岛素用量少，不良反应发生率低，值得临床推广。

Clinical Efficacy of Two Kinds of Insulin Administration Regimen on Type 2 Diabetes Complicating Pulmonary Infection

Objective To compare the clinical efficacy of insulin pump and multiple insulin subcutaneous injection for treating type 2 diabetes mellitus （ T2DM ） complicating pulmonary infection. Methods A total of 102 patients with T2DM complicating pulmonary infec-tion in our hospital from January 2012 to December 2013 were selected and randomly divided into the study group （ 55 cases ） and the control group （ 47 cases ） . The two groups were given the symptomatic therapy of anti-inflammatory, oxygen inhalation, relieving asthma, sputum suction and the support therapy for treating pulmonary infection. The study group was added with the insulin pump and the control group was repeatedly given insulin by subcutaneous injection. The clinical efficacy of pulmonary infection was observed in the two groups. The levels of inflammatory cytokines before and after treatment and glycemic control were detected. The dosage of insulin and adverse reactions were recorded. Results The total effective rate of pulmonary infection after treatment in the study group was 94. 55%, which was significantly higher than 87. 23% in the control group, the difference was statistically significant （ P〈0. 05 ）;the lev-els of inflammatory cytokines including serum interleukin-6,interleukin-8,high-sensitivity C-reactive protein in the study group were significantly lower than those in the control group （ P〈0. 05 ）;the blood glucose level at various time periods and the insulin aver-age dosage in the study group were lower than those in the control group （ P〈0. 01 ）;5 cases （ 9. 09%） of hypoglycemia occurred in the study group, while 12 cases （ 25. 53%） occurred in the control group with statistically significant difference between the two groups （ P〈0. 05 ） , the occurrence of other adverse reactions had no statistical difference （ P〉0. 05 ） . Conclusion Insulin pump has better effect for treating T2DM complicating pulmonary infection, can significantly decrease the levels of inflammatory cytokines, control