甲基强的松龙治疗糖尿病合并慢阻肺后血糖动态变化及对胰岛素方案的影响  

Dynamic Change in Blood Glucose after Treatment of IMethylprednisolone on Diabetes Combined with Chronic Obstructive Pulmonary Disease and Corresponding Influence on Insulin Solution

作　　者：尹镇钊[1] 张秀薇[1] 陈伟坤[1] 叶惠成[1] 禤文婷[1] 

机构地区：[1]东莞市人民医院,广东东莞523000

出　　处：《哈尔滨医药》2017年第2期109-111,共3页Harbin Medical Journal

摘　　要：目的对糖尿病患者合并慢阻肺应用甲基强的松龙治疗其胰岛素使用进行方案调整,并观察血糖动态的变化。方法将我院2014年1月至2015年1月接收的慢阻肺患者180例作为研究对象,按数字表法将其分为3组,每组60例,其中A组患者为慢阻肺合并糖尿病应用甲基强的松龙治疗,B组为慢阻肺合并糖尿病未应用甲基强的松龙治疗,C组为慢阻肺不合并糖尿病应用甲基强的松龙治疗,监测三组患者平均血糖水平、血糖水平>10 mmol/L时间百分比、餐后血糖水平>11.1 mmol/L血糖曲线下面积、餐后血糖波动幅度、餐后血糖峰值以及平均血糖波动幅度等,分析患者使用甲基强的松龙前后的胰岛素剂量改变。结果 A组患者血糖峰值≥11.1 mmol/L的曲线下面积与B组、C组比较明显较高,血糖峰值≥11.1 mmol/L例数与B组、C组比较明显较多,差异有统计学意义(P<0.05),A组24 h平均血糖水平高于B组、C组,差异有统计学意义(P<0.05);A组患者平均血糖幅度明显高于B组与C组,其早餐血糖幅度与C组差异显著,与B组无统计学差异(P>0.05),午餐与晚餐血糖幅度与B组、C组差异具有统计学意义(P<0.05)。结论糖尿病合并慢阻肺患者使用甲基强的松龙治疗,可延迟血糖达峰时间,血糖水平控制应增加胰岛素应用剂量。Objective To conduct the solution adjustment on insulin for the treatment of methylprednisolone on patients with diabetes combined with chronic obstructive pulmonary disease（COPD）,and to observe dynamic changes in the blood glucose.Methods One hundred and eighty patients admitted by the Hospital from January,2014 to January,2015 were selected as research subjects,who were divided into three groups with 60 patients in each group according to the digital meter method,the patients with diabetes mellitus combined with COPD in Group A underwent methylprednisolone therapy,patients with COPD combined with diabetes didn’t undergo methylprednisolone therapy,while patients with COPD without combining diabetes mellitus underwent methylprednisolone therapy,average blood glucose level,time percentage of blood glucose level 〉10mmol L,postprandial blood glucose level 〉11.1 mmol/L,glucose area under the curve,fluctuation range of postprandial blood sugar,peak value of postprandial glucose and average fluctuation of average blood glucose of patients in three group were analyzed,and the change in insulin dosage of patients before and after the application of methyl prednisolone were analyzed.Results The area under the curve of peak value of blood glucose of patients in Group A satisfying ≥11.1mmol/L was significantly higher when compared to that of patients in Group B and Group C,the number of peak value of blood glucose of patients satisfying≥11.1mmol/L were significantly more than those of patients in Group B and Group C and the differences were significant（P〈0.05）,24 hours-average blood glucose level of patients in Group A were higher than that of patients in Group B and Group C,and it was not statistically significant（P〈0.05）;Average blood glucose of patients with Group A was obviously higher than that of Group B and Group C,the difference in breakfast blood sugar range of patients in Group A and that of patients in Group C was different,group B,and there was not statistically different when compared

关 键 词：糖尿病 慢阻肺 甲基强的松龙 动态血糖 胰岛素方案 

分 类 号：R587[医药卫生—内分泌]