动态血糖监测系统和胰岛素泵在ICU糖尿病患者的联合应用  

Application of combined use of continuous glucose monitoring system and continuous subcutaneous insulin infusion pump in critical patients with type 2 diabetic mellitus in ICU

作　　者：黄文龙[1] 张晓兰[1] 方铭[1] 刘云 

机构地区：[1]江阴市人民医院内分泌病科,214400 [2]南京医科大学第一附属医院老年内分泌病科

出　　处：《江苏医药》2011年第3期287-289,共3页Jiangsu Medical Journal

基　　金：江苏省自然科学基金资助项目(BK2007253)

摘　　要：目的探讨动态血糖监测系统(CGMS)和胰岛素泵持续皮下注射治疗(CSII)在重症监护病房(ICU)2型糖尿病(T2DM)患者的应用效果。方法将120例T2DM患者随机均分为三组:A组采用CGMS与CSII结合治疗模式(40例),B组采用单纯CSII治疗(40例),C组采用胰岛素多次注射治疗(40例)。后两组采用指端毛细血糖监测法。治疗7d后比较三组血糖控制情况、血糖达标率及血糖漂移情况。结果治疗7d后,A组和B组患者的全日血糖、平均血糖(MBG)、平均血糖波动幅度(MAGF)均较治疗前明显下降,且明显优于C组(P<0.05),低血糖发生次数亦较C组明显减少(P<0.05)。其中,A组MBG、MAGE、低血糖次数均显著低于B组(P<0.05)。结论 CGMS能监测血糖连续的变化曲线,及时发现高血糖和低血糖,与胰岛素泵联合治疗更有利于ICU糖尿病患者血糖的控制,降低低血糖的发生率。Objective To investigate the therapeutic outcomes of continuous glucose monitoring system（CGMS） and continuous subcutaneous insulin infusion pump system（CSII） in type 2 diabetes mellitus（T2DM） patients with critical condition in intensive care unit（ICU）.Methods A total of 120 T2DM patients in ICU was randomly divided into three groups with 40 cases each.CGMS combined with CSII was used in group A,CSII alone in group B and repeated injection of insulin therapy in group C.The capillary blood glucose of finger tip was monitored in groups of B and C.The changes of fasting blood glucose（FBG）, mean amplitude of glycemic excursions（MAGE） and the number of hypoglycemia events were recorded and compared among three groups after for treatment 7 days.Results After pump therapy for 7 days, the whole day glucose, MBG and MAGE were all significantly lower in groups of A and B than those before treatment（P0.05）,which were lower in group A than those in group B（P0.05）.The mean blood glucose（MBG）, mean amplitude of glucose fluctuation（MAGF） and hypoglycemia events of group A were obviously less than those in group B（P0.05）. Conclusion CGMS can depict a continuous blood glucose curve,discover hyperglycemia or hypoglycemia events. CGMS combined with CSII is more beneficial to the glucose control in the critical T2DM patients in ICU.

关 键 词：2型糖尿病 动态血糖监测系统 胰岛素泵 

分 类 号：R598[医药卫生—内科学]