胰岛素类似物Aspart应用于胰岛素泵治疗2型糖尿病急性并发症疗效分析  

Clinical therapeutic effect analysis of applying insulin analog,Aspart,in isulin pump to treating acute complication of type Ⅱ diabetes

作　　者：王海慧[1] 唐春红[2] 陈星 陈兵[1] 

机构地区：[1]第三军医大学附属西南医院内分泌科,重庆400038 [2]重庆工商大学环境与生物工程学院,重庆400067 [3]重庆市潼南县医院内科,重庆402660

出　　处：《重庆工商大学学报（自然科学版）》2008年第6期642-645,共4页Journal of Chongqing Technology and Business University:Natural Science Edition

基　　金：第三军医大学第一附属医院临床研究专项基金资助(SWH2005A109)

摘　　要：比较了Aspart与短效可溶性胰岛素对高渗性非酮症糖尿病昏迷(hyperosmolar dia-betic nonketotic coma HONK)或酮症酸中毒(diabetic ketoacidosis DKA)的治疗差异。发现胰岛素泵持续皮下注射治疗组和短效可溶性胰岛素(诺和灵R)对照组间年龄、血糖和体重指数(BMI)无显著性差异;观察血糖、血酮、尿酮体及渗透压、血钠的变化,低血糖的发生率,结果表明:(1)两组患者的血糖经治疗后均明显下降,但达标血糖值的时间治疗组较对照组缩短,药物用量较对照组减少,差异较显著;(2)两组患者血酮恢复正常时间、尿酮体转阴时间、血气pH值恢复正常时间与对照组相比均无显著性差异(P>0.05);(3)治疗组低血糖发生率〔(0.32)次/人〕较对照组〔(1.7)次/人〕低,差异有显著意义(P<0.01)。胰岛素类似物Aspart胰岛素泵持续皮下注射治疗DKA、HONK同短效可溶性胰岛素胰岛素泵持续皮下注射均能取得较好疗效,但前者更有效,安全性更好。This paper compares the curative effects of insulin analog, Aspart, In treating hyperosmolar nonketotic diabetic coma（HONK） or diabetic ketoacidosis（DKA） with those of the shortacting and dissoluble insulin in treating HONK or DKA. The hospitalized patients with HONK or with DKA were randomly divided into four groups：the groups of DKA patients treated with Aspart, the group of HONK patients treated with Aspart. These two experimental groups were treated with subcutaneous infusion of Aspart through insulin pump. Two control groups were composed of a group of DKA patients treated with subcutaneous infusion of insulin through insulin pump and a group of HONK treated with insulin by the same method. There were no significant differences in age, blood sugar and body mass index （BMI） among the groups. Such indexes were observed as the changes of blood sugar, blood ketone, urinary ketone, osmotic pressure and blood sodium, and incidence rates of hypoglyce- mia. The results showed that blood sugar of the experimental groups and control groups significantly decreased after treatment, but the time for blood sugar to reach the normal level in the experimental groups was significantly shorter than in the control groups. Besides, the dosage of the Aspart was remarkably smaller than that of insulin in control group. The time for blood ketone, urinary ketone, and pH value of blood gas to recover to normal values in experimental group was not pronouncedly different from that in control group （P 〉 0.05 ）. The incidence rate of hypoglycemia （ time/per person） in the former group was significantly lower than that in latter groups （ P 〈 0.01 ）. Accordingly, both Aspart and insulin had good therapeutic effects on DKA and HONK while continuously infused subcutaneously, but Aspart showed better effects than insulin and was safer than insulin.

关 键 词：胰岛素泵 高渗性非酮症糖尿病昏迷 糖尿病酮症酸中毒 胰岛素类似物 ASPART 

分 类 号：R917[医药卫生—药物分析学]