多次胰岛素注射与胰岛素泵治疗妊娠糖尿病的有效性及安全性比较  

A comparative study of transient intensive insulin treatment by multiple daily injections versus continuous subcutaneous insulin infusion in gestational diabetes mellitus

作　　者：赖丽萍[1] 凤香清 蒋凤秀[1] 叶艺艺[1] 桑丹 赖凤华 陆泽元[1] 

机构地区：[1]深圳市第四人民医院内分泌科,518033

出　　处：《临床内科杂志》2016年第9期601-603,共3页Journal of Clinical Internal Medicine

基　　金：深圳市科技创新研发资助项目（20140330145307）

摘　　要：目的比较分析多次胰岛素注射与胰岛素泵治疗妊娠糖尿病（GDM）的有效性及安全性。方法将162例胰岛素治疗的GDM患者随机分为两组，采用胰岛素泵治疗（CSII组）81例，超短效胰岛素类似物每天多次注射并提供基础量的地特胰岛素联合治疗（MDI组）81例，比较两组患者胰岛素治疗前后血糖变化、血糖达标时间、胰岛素最大用量及治疗期间低血糖事件发生率。结果两组间血糖达标时间比较差异无统计学意义（P〉0．05）。达标时MDI组晚餐后2h血糖高于CSII组（P〈0．05）。两组间胰岛素注射总量差异无统计学意义，MDI组的基础胰岛素占胰岛素总量的百分比少于CSII组（9％与15％，P〈0．01），但三餐前注射胰岛素剂量比较差异无统计学意义（P〉0．05）。两组低血糖事件发生率之间的差异无统计学意义（P〉0．05）。结论MDI与CSII对短期强化治疗GDM患者均有效，且安全性一致。Objective To analyze the efficacy and safety of treatment by multiple daily insulin injections（MDI, using insulin aspart and insulin detemir） or continuous subcutaneous insulin infusion （CSII,using insulin aspart） on patients with gestational diabetes mellitus （GDM）. Methods 162 GDM women with insulin treatment were divided into MDI group（ n = 81 ） and CSII group（ n = 81 ） randomly. Blood glucose level, time for the successful treatment, total insulin dosage and incidence of hypoglycemia were evaluated. Results There was no difference in the time of achieving blood glucose goal between two groups. Two-hour blood glucose was higher in MDI group than that in CSII group（P 〈 0.05 ）. Total insulin dosage was not significantly different between the two groups. The percentage of basal insulin in the MDI group（9% ） was less than that in CSII group（ 15% ,P 〈0.01 ）. However,the dosage of mealtime insulin was similar in the two groups. The incidence of hypoglycemia was not significantly different between the two group. Conclusion Our study showes that the efficacy and safety of CSII and MDI in the treatment of GDM were similar.

关 键 词：持续皮下胰岛素输注 胰岛素泵 多次胰岛素注射 地特胰岛素 妊娠糖 尿病 

分 类 号：R587.105[医药卫生—内分泌]