实时动态血糖监测在高血糖急性并发症中的应用  

The clinical use of real-time continuous glucose monitoring in Hyperglycemic crises in adult patients with diabetes

作　　者：蒙雯雯[1] 莫建勋[1] 孙文波[1] 唐盛发[1] 莫剑峰[1] 陈植涛[1] 叶烨[1] MENG Wen-wen;MO Jian-xun;Sun Wen-bo;TANG Sheng-fa;MO Jian-feng;Chen Zhi-tao;YE Ye(Department of endocrinology > Guilin of Guangxi Chinese peoples Liberation Army 181 hospital,Guilin ,541002)

机构地区：[1]中国人民解放军第一八一医院内分泌科,广西桂林541002

出　　处：《世界中医药》2017年第A01期47-47,50,共2页World Chinese Medicine

基　　金：桂林市科学研究与技术开发计划项目项目;编号:20150126-2-2

摘　　要：目的动态血糖监测可以实时反应血糖及其变化趋势，我们旨在应用实时动态血糖监测观察高血糖急性并发症患者血糖波动情况。方法选择2013年4月至2015年4月在本院住院期间确诊为高血糖急性并发症（包括糖尿病酮症酸中毒及高血糖高渗综合征）的病例共30例，其中15例选择实时动态血糖监测系统（RT-CGMS)，15例选择常规指尖血糖监测，两组均监测72h，比较两组整体血糖控制水平、过高血糖（血糖>20mrnol/L)发生、低血糖（血糖<3.9mmol/L)发生、纠正高血糖急性并发症所用时间等情况。结果经过72h血糖监测并据血糖调整肢岛素剂量，动态血糖监测组平均血糖水平第2天（12±2.9)mmol/L，第3天（9.5士2.4)mmol/L，指尖血糖组平均血糖水平第2天（14士3.8)mrnol/L，第3天（11±3.2)mmol/L，纠正高血糖所用时间CGMS组（3.2±1.2)天，常规指尖血糖监测组（4.5±1.6)天。结论将实时动态血糖监测系统应用于高血糖急性并发症更有利于血糖控制，有效避免高血糖及低血糖发生，减少血糖波动，并缩短高血糖代谢紊乱纠正所用时间，在高血糖急性并发症治疗中有较高应用价值。Objective Real-timecontinuousglucose monitoring(RT-CGMS)can reflect the glycemic change,we aimed to use RT-CGMS to observe the fluctuation of Hyperglycemic crises in adult patients with diabetes.Methods We choosed the thirty patients that diagnosed Hyperglycemic crises from April2013to April2015in our department(Including diabetic ketoacidosis and diabetic nonketotic hyperosmolar syndrome).Fifteen patients used RT-CGMS and the others used fingertip blood glucose monitoring.All of them were monitored by72hours.We compared two groups of overall control of blood glucose level,high blood sugar(more than20mmol/l),low blood sugar(less than3.9mmol/l),and corrected hyperglycemia and acute complications time.Results the average blood glucose levels in the RT-CGMS group was(12±2.9)mmol/l in the second day and(9.5±2.4)mmol/l in the third day.In fingertip blood glucose group,the average blood glucose level was(14±38)mmol/l in the second day and(11±3.2)mmol/l in the third day.Corrected hyperglycemia time in RT-CGMS group was(3.2±1.2)days,and fingertip blood glucose group was(4.5±1.6)days.Conclusions Real-time continuous glucose monitoring system in Hyperglycemic crises was more conducive to control blood sugar,effectively prevent the occurrence of hyperglycemia and hypoglycemia,and decrease the fluctuation of blood glucose and relationship high blood glucose metabolic disorders in correct time.In the treatment of complications of acute hyperglycemia has higher application value.

关 键 词：实时动态血糖监测 糖尿病酮症酸中毒 高血糖高渗综合征 

分 类 号：R3[医药卫生—基础医学]