短期胰岛素强化治疗重症肺炎合并血糖异常临床研究  

Clinical study of short-term insulin intensive therapy for severe pneumonia complicated with pathoglycemia

作　　者：靳莉[1] 曹砚杰 张华[1] 

机构地区：[1]郑州大学附属郑州中心医院,河南郑州450000

出　　处：《临床心身疾病杂志》2016年第4期31-33,共3页Journal of Clinical Psychosomatic Diseases

基　　金：河南省高等学校重点科研项目（编号15A320036）

摘　　要：目的：探讨短期胰岛素强化治疗重症肺炎合并血糖异常的临床效果。方法将76例重症肺炎合并血糖异常患者按随机数字表法分为观察组和对照组，每组38例，均应用抗生素有效控制感染，观察组给予胰岛素强化治疗，对照组给予常规降糖治疗，观察5d。治疗前后检测血小板计数、C反应蛋白和空腹血糖水平的变化，比较两组有效率和并发症发生率。结果治疗后观察组血小板计数、C反应蛋白水平较治疗前显著升高，空腹血糖水平较治疗前显著下降（P＜0．05或0．01），血小板计数显著高于对照组，C反应蛋白及空腹血糖水平显著低于对照组（ P＜0．05或0．01）。观察组总有效率（94．7％）显著高于对照组（78．9％）（χ2＝4．15，P＜0．05）；观察组并发症主要表现为低血糖，发生率（73．7％）显著高于对照组（47．4％）（χ2＝5．51，P＜0．05）。结论短期胰岛素强化治疗重症肺炎合并血糖异常患者能显著降低高炎症反应状态，有利于控制感染和控制血糖水平，提高临床疗效，但在治疗过程中应加强血糖监控，预防低血糖的发生。Objective To explore the clinical effects of short‐term insulin intensive therapy for severe pneumonia complicated with pathoglycemia .Methods Seventy‐six severe pneumonia patients with patho‐glycemia were randomly assigned to two groups of 38 ones each ,both groups were treated with antibiotic to control infection effectively ,observation group received insulin intensive therapy ,and control group did routine hypoglycemic treatment for 5 days .Changes of blood platelet count （BPC） ,C‐reactive protein （CRP） and fasting blood‐glucose （FBG） were detected before and after treatment ,group effective rates and complications incidences compared .Results After treatment BPC and CRP levels heightened more significantly and FBG lowered （P〈0 .05or 0 .01） in observation group ,BPC was significantly higher and CRP and FBG were lower than in control group （P〈0 .05or 0 .01） .Total effective rate was significantly higher in observation than in control group （94 .7% vs .78 .9% ,χ2 =4 .15 ,P〈0 .05）;main complication was hypoglycemia in observation group , its incidence significantly higher than that in control group （73 .7% vs .47 .4% ,χ2 =5 .51 ,P〈0 .05） .Conclusion Short‐term intensive insulin treatment for severe pneumonia complicated with pathoglycemia could notably lower high inflammatory reaction state ,is bene‐ficial to the control of blood sugar level ,boost clinical effect ,but blood glucose should be monitored during treatment to prevent the development of hypoglycemia .

关 键 词：肺炎 血糖异常 胰岛素 强化治疗 并发症 糖尿病 心身疾病 

分 类 号：R563.1[医药卫生—呼吸系统] R587.1[医药卫生—内科学]