肝源性糖尿病与2型糖尿病患者临床和预后情况的差异及相关护理  

Clinical characteristics, prognosis and nursing intervention in hepatogenic diabetes and type 2 diabetes mellitus

作　　者：王少萍[1] 吴玉萍[1] 林小洁[1] 

机构地区：[1]海南省人民医院心血管内科,海南省海口市570311

出　　处：《世界华人消化杂志》2014年第24期3722-3726,共5页World Chinese Journal of Digestology

摘　　要：目的:了解肝源性糖尿病(hepatic diabetes,HD)与2型糖尿病(type 2 diabetes mellitus,T2DM)的临床特点,探讨HD和T2DM患者临床和预后情况的差异,及临床护理干预前后的血糖控制情况.方法:HD患者30例和T2DM患者30例入组本研究.分为HD组(30例)和糖尿病无肝硬化组(30例).两组均进行糖耐量试验及胰岛素释放试验.监测空腹血糖和糖化血红蛋白.同时给予内科治疗、降糖治疗及内科护理干预,比较临床护理干预前后的血糖控制情况.结果:(1)HD组空腹血糖(7.8 mmol/L±2.4 mmol/L)和糖化血红蛋白水平(0.065±0.017)显著低于T2DM组(9.6 mmol/L±3.2 mmol/L)和(0.083±0.027),差异均有统计学意义(t=1.017、0.976,P=0.002、0.004).HD组葡萄糖耐量试验各时间点(0、30、60、120、180 min)的血糖水平均显著低于T2DM组,差异均有统计学意义(均P<0.05);(2)胰岛素释放试验各时间点(0、30、60、120、180 min)的胰岛素水平及C肽水平均显著高于T2DM组,差异均有统计学意义(均P<0.05);(3)所有入组患者给予内科治疗、降糖治疗及内科护理干预后,HD组与T2DM组空腹血糖及糖化血红蛋白较前明显下降,差异有统计学意义(t=2.076、1.872、2.301、1.874,P=0.003、0.004、0.002、0.004).结论:HD患者存在高胰岛素血症,血糖水平控制好于T2DM患者.对于HD与T2DM患者,除给予内科治疗治疗外,实施有效的综合护理干预,能够改善血糖控制情况,值得临床进一步推广使用.AIM： To compare the clinical characteristics, prognosis and nursing intervention between pa-tients with hepatogenic diabetes（HD） and those with type 2 diabetes（T2DM）. METHODS： Sixty patients with hyperglycaemia were divided into two groups： an HD group（n = 30） and a T2 DM group（n = 30）. Oral glucose tolerance test（OGTT） and glucose-stimulated in-sulin release test were performed in all patients. The levels of fasting blood glucose（FBG） and glycosylated hemoglobin（HbAlc） were deter-mined. All patients were given medical manage-ment, hypoglycemic therapy and comprehen-sive nursing intervention. BSL were comparedbetween before and after nursing intervention. RESULTS： FBG and HbAlc in the HD group were significantly lower than those in the T2 DM group（7.8 mmol/L ± 2.4 mmol/L vs 9.6 mmol/L ± 3.2 mmol/L, 0.065 ± 0.017 vs 0.083 ± 0.027, t = 1.017, 0.976; P = 0.002, 0.004）. BSL in the HD group at different time points（0, 30, 60, 120, 180 min） were all significantly lower than those in the T2 DM group（P〈0.05）. Insulin and peptide C levels in the HD group at different time points（0, 30, 60, 120, 180 min） were all significantly higher than those in the T2 DM group（P〈0.05）. All patients were given medical management, hypoglycemic therapy and comprehensive nurs-ing intervention. BSL in both the HD group and T2 DM group were significantly lower after intervention than before intervention（t = 2. 076, 1.872, 2.301, 1.874; P = 0.003, 0.004, 0.002, 0.004）. CONCLUSION： Hyperinsulinemia is more obvi-ous and BSL is controlled better in HD patients. Comprehensive nursing intervention is condu-cive to controlling BSL in both HD and T2 DM patients.

关 键 词：肝源性糖尿病 2型糖尿病 葡萄糖耐量试验 C肽 胰岛素 

分 类 号：R473.5[医药卫生—护理学]