1型糖尿病患者胰岛素治疗方案及注射装置的现状分析  

Status quo of insulin treatment protocol and injection instrument in patients with type 1 diabetes mellitus

作　　者：叶凯云[1] 吴伟英[1] 卢瑛[1] 梁干雄[1] 尚治新[1] 林泽宏 李亿琴[3] 黄汉伟[4] 濮先明[5] 

机构地区：[1]中山市人民医院内分泌科,广东中山528403 [2]中山市人民医院内六科,广东中山528403 [3]中山市博爱医院内分泌科,广东中山528402 [4]中山市陈星海医院内分泌科,广东中山528415 [5]中山市小榄人民医院内分泌科,广东中山528415

出　　处：《广州医学院学报》2014年第2期58-61,共4页Academic Journal of Guangzhou Medical College

摘　　要：目的:了解不同胰岛素治疗方案及注射装置对1型糖尿病(T1DM)患者血糖控制的影响。方法:横断面调查在中山市登记的T1DM患者的临床资料,收集的血、尿标本;比较胰岛素泵组、胰岛素笔式注射器(胰岛素多次皮下注射组和混合胰岛素皮下注射组)、注射器组的HbA1c水平。结果:共调查168例T1DM患者,其中43例(25.6%)达到相应年龄的血糖控制目标。胰岛素泵组、胰岛素笔式注射器(胰岛素多次皮下注射组和混合胰岛素皮下注射组)、注射器组患者的HbA1c水平比较,差异无统计学意义(P>0.05);HbA1c与胰岛素用量呈正相关,与体质指数(BMI)、就诊次数、自我血糖监测(SMBG)频率、病程、年龄呈负相关(P<0.05)。结论:参与调查的T1DM患者血糖控制差;选择不同胰岛素治疗方案及注射装置对血糖控制无影响:适当增加患者体质量、增加就诊次数及血糖监测频率有助血糖控制。Objective:To assess the influences of different treatment protocols and injection instruments on blood glycemic control in patients with type 1 diabetes mellitus(TIDM).Methods:A survey was conducted on the TIDM patients in Zhongshan city.We recorded the clinical profiles and collected blood and urine samples for a cross-sectional investigation.This entailed comparison on the levels of glycosylated hemoglobin(HbAlc)between patients treated with continuous subcutaneous insulin infusion(CSII),the insulin pen injector(multiple daily injections and premixed insulin injection) and the conventional injector.Results:Of the 168 patients who were surveyed,43(25.6%) achieved the age-specific target levels.The difference in HbAlc among the three groups was unremarkable(P>0.05).The HbAlc was positively correlated with insulin dosage administered per day and inversely correlated with the body mass index,the frequency of out-patient clinic visits,frequency of self-monitoring of blood glucose,the duration of TIDM and the age(all P<0.05).Conclusion:TIDM patients did not achieved the targeted level of blood glucose control in our survey.The therapeutic effects of different routes for insulin treatment did not significantly influence on the blood glucose levels.Glucose control could be better achieved via a certain magnitude of increase in the body-mass index and the frequency of out-patient clinic visits and self-monitoring of blood glucose levels.

关 键 词：1型糖尿病 胰岛素 治疗方案 注射装置 血糖控制 

分 类 号：R587.1[医药卫生—内分泌]