联合应用甘精胰岛素和门冬胰岛素治疗儿童1型糖尿病疗效初步观察  

Combined Therapy of Insulin Glargine (IG) and Insulin Aspart (IA) in Children with Type 1 Diabetes Mellitus:A Primary Observation

作　　者：阎丽华[1] 陈志红[1] 张颖[1] 解秀文[1] 徐爱晶[1] 田飞[1] 李堂[1] 

机构地区：[1]青岛大学医学院附属医院儿内科,山东青岛266003

出　　处：《现代生物医学进展》2010年第2期339-341,共3页Progress in Modern Biomedicine

摘　　要：目的:观察联合应用甘精胰岛素和门冬胰岛素治疗儿童1型糖尿病(type1diabetes mellitus,T1DM)的临床效果。方法:比较12例采用传统治疗方案(诺和灵30R,2/3量早餐前半小时皮下注射,1/3量晚餐前半小时皮下注射)的T1DM患儿,改用3+1治疗方案(3餐前0-15分钟诺和锐皮下注射,睡前来的时皮下注射)治疗后HbA1c水平、低血糖发生和胰岛素用量变化。结果:12例T1DM患儿改用3+1方案治疗时HbA1c基础值为9.51±0.71%,治疗后3个月时为9.12±0.82%,6个月时为8.61±0.87%、9个月时为8.71±0.68%、12个月时为8.65±0.79%。换用3+1方案治疗后第6、9、12个月时HbA1c值较基础值明显降低,差异有统计学意义(P<0.05)。每日胰岛素用量由1.1±0.8U/kg降至1.0±0.5U/kg,差异无统计学意义。传统方案治疗期间,6例次发生过严重低血糖,改用3+1治疗方案后,无1例发生严重低血糖。轻中度低血糖的发生次数由2.2±0.1次/周降至1.3±0.1次/周,差异有显著统计学意义(P<0.001)。结论:采用传统治疗方案治疗的T1DM患儿,改用甘精胰岛素和门冬胰岛素联合治疗后在不增加胰岛素用量的前提下,获得较好血糖控制,低血糖的发生频率明显降低,取得较好临床效果。Objective：To observe the primary effect of therapy using a combination of insulin glargine（IG） and insulin aspart（IA） in children with type 1 diabetes. Methods：12 patients with type 1 diabetes were treated with IG and IA after using traditional treatment（Novolin 30R was used to subcutaneous inject,two-thirds of the amount half of an hour before breakfast,one-third of the amount half of an hour before dinner） . During the insulin analogues therapy,thrice-daily IA was used zero to fifteen minutes before meals plus once-daily IG before sleep. The numbers of nonsevere and severe hypoglycemic events,hemoglobin A1c values and daily insulin dose were recorded at each clinic visit. The clinical materials and the results of follow-up for 12 months were analyzed retrospectively in all patients. Results：All patients completed the study. The mean hemoglobin A1c levels were 9.51±0.71 %（baseline） ,9.12±0.82 % at 3 months（P0.05） ,8.61±0.87 % at 6 months（P0.05） ,8.71±0.68 % at 9 months（P0.05） ,8.65±0.79 % at 12 months（P0.05） . There was an insigni？cant decrease in daily insulin requirement in patients from 1.1±0.8 U/kg to 1.0±0.5 U/kg. The mean frequency of nonsevere hypoglycemic events per week decreased from 2.2±0.1 to 1.3±0.1. There was no severe hypoglycemic happened. Conclusion：The combined therapy of insulin glargine;insulin aspart is an effective treatment for children with type 1 diabetes mellitus than the traditional treatment. Without increasing the daily dose of insulin,the blood glucose was better controlled,the incidence of hypoglycemia was reduced in 3＋1 treatment than in traditional treatment.

关 键 词：甘精胰岛素 门冬胰岛素 1型糖尿病 儿童 

分 类 号：R725.8[医药卫生—儿科]