无针注射器INJEX30和胰岛素笔对糖尿病患者皮下注射胰岛素吸收状况的对照研究  

A comparative study of the effects of needle free （INJEX30） versus insulin pen injection on insulin absorption in diabetic patients

作　　者：周美岑[1] 王雁[2] 董亚秀[1] 孙琦[1] 李玉秀[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院内分泌科,100730 [2]空军航空医学研究所附属医院内分泌科

出　　处：《中华内科杂志》2013年第9期741-744,共4页Chinese Journal of Internal Medicine

摘　　要：目的观察糖尿病患者应用无针注射器INJEX30和胰岛素笔对胰岛素吸收和血糖控制的影响。方法30例病情稳定接受胰岛素治疗的糖尿病患者应用无针注射器INJEX30和胰岛素笔进行随机交叉自身前后对照，试验期间两种不同注射方式之间间隔3d，空腹及标准餐后20、40、60min采血标本测定血浆葡萄糖、血清总胰岛素和C肽。结果标准餐刺激后血糖、C肽的曲线下面积（AUC）INJEX30组小于胰岛素笔注射组[血糖AUC：（542±172）min-mmol·L-1比（601±199）min·mmol·L-1，P〈0．01；C肽AUC：（70±53）min·μg·L-1比（80±58）min·pug·L-1，P〈0．01]。血清总胰岛素AUCINJEX30组大于胰岛素笔注射组[（5621±3790）min·mlU·L-1比（4285±3376）min·mlU·L-1，P〈0．01]。体重指数（BMI）〈25．24ks／m2时，两种胰岛素注射方式的总胰岛素AUC差异无统计学意义，BMI≥25．24ks／m2时，总胰岛素AUCINJEX30组高于胰岛素笔注射器组[（6453±4099）min·mlU·L-1。比（4879±3701）min·mlU·L-1，P〈0．01]。结论无针注射器INJEX30注射胰岛素较胰岛素笔注射者血清总胰岛素浓度高、血糖较低；且在BMI较高的糖尿病患者中，无针注射器注射后较胰岛素笔注射血清总胰岛素浓度高。Objective To evaluate the effect of the needle free injection system （INJEX30） and insulin pen on insulin absorption and glyeemie control in diabetic patients. Methods A total of 30 diabetic patients on insulin therapy without obvious complications were enrolled in the study with average BMI of 25.24 kg/m2. A comparison study was carried out in those subjects with the INJEX30 and insulin pen at 18t day and 5th day. After an overnight fasting of 8-10 h, a standard mixed meal（50 g bread,50 g egg and 250 ml milk） was given to each patient. Blood samples at 0, 20,40,60 rain of the standard mixed meal were collected to test plasma glucose, serum insulin and C peptide. Results No difference was shown in fasting plasma glucose, serum insulin and C peptide between the patients with the two injection methods. The area under the curve （AUC） of plasma glucose and serum C peptide was significantly lower after the INJEX30 injection than that after insulin pen injection [plasma glucose AUC （542 ± 172）min mmol L-1 vs （601±199） min-mmol L-1, P〈0.01; C peptide AUC （70 ±53） min μg L-1 vs （80 ±58） min μg L-1 ,P 〈0. 011. The AUC of serum insulin was significantly higher after the INJEX30 injection than that after insulin pen injection [ serum insulin AUC（5621 ± 3790） rain mIU L-1 vs（4285 ± 3376） min mIU L-1 ,P 〈0. 01 ]. No difference was found in the AUC of serum insulin between the two injection methods in the patients with BMI below 25.24 kg/m2, while the AUC of serum insulin was significantly higher after the INJEX30 injection than the insulin pen injection in the patients with BMI above 25.24 kg/m2 [ serum insulin AUC（6453 ± 4099 ） rain mIU L-1 vs （4879 ± 3701 ） min mIU L-1 , p 〈 0. 01 ]. Conclusion The INJEX30 improves the serum insulin level which may lead to a beneficial effect on the glycemic control. Such effect is more obvious in the overweight patients.

关 键 词：糖尿病 胰岛素 注射 皮下 

分 类 号：R587.1[医药卫生—内分泌]