扫描式葡萄糖监测系统在儿童1型糖尿病患者中的应用观察  

Application of flash glucose monitoring system in children with type 1 diabetes mellitus

作　　者：白金磊 马瑜瑾 李利平 付留俊[1] 刘婕[1] 胡可嫣 卫海燕[3] 王俊宏[4] 郭向阳 耿秀琴[6] 陈民 田德增[8] 沈亚非[9] 田军航 吴海霞[11] 穆雅慧[12] 金文博 赵菊珍[14] 王连伟 赵志刚 王宏运 姜宏卫[1] Bai Jinlei;Ma Yujin;Li Liping;Fu Liujun;Liu Jie;Hu Keyan;Wei Haiyan;Wang Junhong;Guo Xiangyang;C.eng Xiuqin.Chen Min;Tian Dezeng;Shen Yafei;Tian Junhang;Wu Haixia;Mu Yahui.Jin Wenbo;Zhao Juzhen;Wang Lianwei;Zhao Zhigang;Wang Hongyun;Jiang Hongwei(Luoyang Clinical Medicine Research Center of Endocrine and Metabolic Disease;Department of Endocrinology,The First Affiliated Hospital,and College of Clinical Medicine of Henan University of Science and Technology,Luoyang 471003,China)

机构地区：[1]河南科技大学临床医学院河南科技大学第一附属医院内分泌科洛阳市内分泌代谢病临床医学研究中心,471003 [2]河南科技大学护理学院 [3]郑州大学附属儿童医院郑州儿童医院 [4]平顶山市第一人民医院 [5]信阳市中心医院 [6]新乡市中心医院 [7]平顶山市第二人民医院 [8]濮阳市安阳地区医院 [9]漯河市中心医院 [10]洛阳市第三人民医院 [11]濮阳市人民医院 [12]黄河三门峡医院 [13]南阳市中心医院 [14]焦作市人民医院 [15]驻马店中心医院 [16]郑州颐和医院

出　　处：《中华糖尿病杂志》2018年第10期658-662,共5页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：河南省科技计划项目（1223410406）;河南省省直医疗机构医疗服务能力提升工程建设项目

摘　　要：目的初步了解河南省儿童1型糖尿病（TIDM）患者血糖控制现状，观察扫描式葡萄糖监测系统（FGMS）在T1DM患儿中应用的安全性。方法选择2017年8月至2018年2月河南科技大学第一附属医院等15家河南省三级医院内分泌科门诊T1DM患儿116例，年龄≤14岁，均采用持续皮下胰岛素输注（CSII）或每日多次胰岛素注射（MDI）治疗，入选后佩戴FGMS 2周，记录FGMS监测期间各项血糖指标，监测不良事件，并分析糖尿病病程、胰岛素注射方式等因素对血糖控制的影响。采用t检验、方差分析或秩和检验比较组间差异，相关性采用偏相关性分析。结果患儿基线HbA1c为（8.3±1.7）%。FGMS监测期间，预估HbA1c为（7.8±1.3）%，平均血糖为（9.8±2.1）mmol/L，目标范围血糖（3.9~7.8 mmol/L）时间百分比为（37±14）%，低血糖（〈3.9 mmol/L）时间百分比为4%（3,8）%，血糖标准差（SDBG）为（4.1±1.2）mmol/L，平均血糖波动幅度（MAGE）为（8.4±2.5）mmol/L。与MDI组相比，CSII组患儿的SDBG、MAGE均显著降低（分别为t=2.65、2.51，均P〈0.05）。偏相关性分析显示，SDBG、MAGE与基线HbA1c呈正相关（分别r=0.401、0.357，均P〈0.05）。研究期间无仪器相关不良事件发生，FGMS传感器的脱落在冬季显著减少。结论河南省14岁以下T1DM患儿HbA1c水平偏高，低血糖发生率高，血糖波动性大。在T1DM患儿中应用FGMS是安全的，通过减少FGMS传感器的暴露可能有助于减少脱落。Objective To investigate the status of blood glucose control in children with type 1 diabetes mellitus （T1DM） in Henan Province, and the safety of flash glucose monitoring system （FGMS） in children with T1DM.Methods Between August 2017 and February 2018, 116 children with TIDM from the Department of Endocrinology in 15 hospitals were selected, including the First Affiliated Hospital of Henan University of Science and Technology and other tertiary hospitals in Henan province. All patients were younger than 14 years old and treated with either continuous subcutaneous insulin infusion （CSII） or multiple daily insulin injection （MDI）. All patients wore FGMS for 2 weeks after the selection. Various glucose monitoring indicators and adverse events were recorded during the application of FGMS, and the effects of diabetes duration, insulin injection model and other factors on blood glucose control were also analyzed. The t test, analysis of variance and rank sum test were used to compare the differences between groups, the correlation was analyzed by partial correlation.Results The baseline glycated hemoglobin A1c （HbA1c） was （8.3±1.7）%. During the application of FCMS, the estimated HbA1c was （7.8±1.3）%, the mean blood glucose was （9.8±2.1） mmol/L, and the percentage of time of blood glucose reaching the target （3.9-7.8 mmol/L） was （37±14）%. The percentage of time of hypoglycemia （〈3.9 mmol/L） was 4% （3, 8）%. The standard deviation of blood glucose （SDBG） was （4.1±1.2） mmol/L and the mean amplitude of glycemic excursion （MAGE） was （8.4±2.5） mmol/L. The SDBG and MAGE in CSII group were decreased compared with MDI group （t=2.65, 2.51, both P〈0.05）. The partial correlation analysis showed that the SDBG as well as the MAGE was positively correlated with the baseline HbA1c （r=0.401, 0.357, both P〈0.05）. No adverse events related to FGMS was recorded during the study period. The drop rate of FGMS sensors was decreased significantly in winter.Co

关 键 词：糖尿病 1型 儿童 扫描式葡萄糖监测 血糖变异性 

分 类 号：R587.1[医药卫生—内分泌]