重型脑卒中伴高血糖实时“滴定”模式的研究  

Realtime titration model used to control hyperglycemia caused by severe cerebral stroke

作　　者：杨中良[1] 刘卫东[2] 陈菊萍[3] 丁勇[2] 张宇一[2] 周竟崎[1] 牛惠燕[4] 

机构地区：[1]上海市浦南医院NICU,上海市蓝十字医学科学研究所,上海200125 [2]上海市浦南医院神经外科,上海市蓝十字医学科学研究所,上海200125 [3]上海市浦南医院内分泌科,上海200125 [4]上海市东方医院中心ICU,上海200120

出　　处：《中国现代医学杂志》2009年第18期2814-2816,2820,共4页China Journal of Modern Medicine

摘　　要：目的探讨实时"滴定"模式对重型脑卒中并发高血糖的调控作用。方法将入院后伴高血糖的重型脑卒中患者85例随机纳入治疗组和对照组,分别以优泌林70/30皮下注射和诺和灵R静脉注射"滴定",分析血糖调控效果及院内感染发生率和病死率。结果治疗组平均血糖值明显低于对照组(P=0.000),血糖达标率明显高于对照组(P=0.000),平均血糖达标时间明显短于对照组(P=0.000),而2组低血糖发生率差异无显著性。治疗组院内感染率和病死率明显低于对照组(P=0.000)。结论实时"滴定"模式可及时、有效、持续地对重型脑卒中并发的高血糖进行调控,有利于降低院内感染率和病死率。[ Objective ] To explore the effect of realtime titration model on the control of hyperglycemia after severe cerebral stroke. [Methods] 85 consecutive cases of severe stroke with hyperglycemia after ICU admission were randomly assigned to pilot group treated by continuous intravenous titration of short-action insulin Novolin R and control group by subcutaneous premixed insulin humulin 70/30 twice a day. The effect of blood glucose control, morbidity of nosocomial infection and mortality of each group were analyzed. [Results ] Compared with control group, the pilot group exhibited significantly lower mean BG （P =0.000）, higher percentage of BG levels in ideal range （P =0.000）, shorter mean time to reach target BG （P =0.000）, similar percentage of hypoglycemia, and showed lower nosocomial infection rate and lower mortality （both P 〈0.05）. [ Conclusions ] The realtime titration model could promptly, effectively and continuously control hyperglycemia caused by severe stroke, being beneficial to lowering nosocomial infection rate and mortality.

关 键 词：脑卒中 高血糖 胰岛素 滴定 

分 类 号：R743[医药卫生—神经病学与精神病学]