联合调整血糖治疗肺心病合并2型糖尿病临床分析  

Clinical analysis of comprehensive therapy for adjusting blood glucose in chronic pulmonary heart disease combined with type 2 diabetes mellitus

作　　者：苑学 冯永莉 李美 孙永利[2] 刘飞[3] 朱秋祥 薛峰 于军 杜高洁 

机构地区：[1]昌黎县人民医院,河北秦皇岛066600 [2]解放军第二五二医院呼吸内科,河北保定072150 [3]清华大学生物医学工程系,北京100084 [4]昌黎县新农村合作医疗管理中心,河北秦皇岛066600

出　　处：《中国急救医学》2012年第11期993-996,共4页Chinese Journal of Critical Care Medicine

摘　　要：目的探讨联合调整血糖治疗慢性肺源性心脏病（CPHD）合并2型糖尿病（T2DM）的临床疗效。方法选择CPHD合并T2DM患者120例，按数字随机法分为治疗组和对照组，两组均给予综合治疗。治疗组（n=60）：应用格列美脲（亚莫利）口服＋甘精胰岛素（来得时）皮下注射调整血糖。对照组（n=60）：小剂量正规胰岛素（诺和灵R）持续静滴。比较两组住院时间、血糖达标时间、低血糖发生率、胰岛素用量、糖化血红蛋白[HbA1c（％）]、空腹血糖（FBG）、餐后2h血糖（2hPBG）、心功能等情况。结果与对照组比较，治疗组住院时间短，胰岛素用量少，低血糖发生率低（P〈0．05）。两组HbA1c（％）、FBG、2hPBG治疗后均下降（P〈0．05），且治疗组下降更明显（P〈0．05）。结论应用格列美脲（亚莫利）口服＋甘精胰岛素（来得时）皮下注射联合调整血糖治疗CPHD合并T2DM，血糖控制稳定，有利于开展治疗，病情缓解快，安全有效。Objective To discuss the curative effect of comprehensive therapy for adjusting blood glucose in chronic pulmonary heart disease （CPHD）combined with type 2 diabetes mellitus （T2DM）. Methods 120 patients of CPHD combined with T2DM were divided into two groups （the treatment group and the control group） by the digital random method, and both groups were given comprehensive therapy. In the treatment group （ n = 60 ） ： blood glucose was adjusted by taking Glimepiride （Amaryl）orally and insulin glargine （Lantus） subcutaneous injection. The control group （n = 60） ： regular small doses of regular insulin （ Novolin R） was continuously infused. The clinical effects, hospital stays, blood glucose time, incidence of hypoglycemia, insulin dosage, Glycated hemoglobin[ HbA1c（ % ） ], fasting blood -glucose（FBG）, 2 h postprandial blood glucose（2 h PBG）, cardiac function were all compared in the two groups. Results （1）In the treatment group, hospital stays was shorter, insulin dosage was less, the incidence of hypoglycemia was lower, and the two groups＇ differences had statistical significance（P 〈 0.05）. （2）HbA1c（% ）, FBG, average 2 h PBG in both groups descended after treatment（ P 〈 0.05 ）, and the decrease was more obvious in the treatment group, and the differences had statistical significance in two groups （ P 〈 0.05 ）. Conclusion Comprehensive therapy of taking Glimepiride （Amaryl） orally and insulin glargine （Lantus） subcutaneous injection in treating CPHD combined with T2DM is useful to control blood glucose, and alleviate the illness condition. The way is safe and effective.

关 键 词：联合 调整血糖 慢性肺源性心脏病(CPHD) 2型糖尿病(T2DM) 

分 类 号：R587.1[医药卫生—内分泌]