糖尿病合并持续植物状态胰岛素注射患者低血糖的发生情况  

Occurrence of hypoglycemia in insulin-injecting diabetic patients with persistent vegetative state

作　　者：李国英[1] 程千鹏 张蕙 李慧莉 LI Guoying;CHENG Qianpeng;ZHANG Hui;LI Huili(The Third Department of Cadre Ward,the Seventh Medical Center,PLA General Hospital,Beijing 100700,China;Department of Endocrinology,the Seventh Medical Center,PLA General Hospital,Beijing 100700,China)

机构地区：[1]解放军总医院第七医学中心干三科,北京100700 [2]解放军总医院第七医学中心内分泌科,北京100700

出　　处：《中国医药导报》2019年第27期69-72,共4页China Medical Herald

摘　　要：目的探讨糖尿病合并持续植物状态胰岛素注射患者低血糖的发生及原因。方法选取2017年2月~2018年3月于解放军总医院第七医学中心干部病房三科住院的糖尿病合并持续植物状态胰岛素皮内注射控制血糖的患者40例,行血糖监测。依据是否发生低血糖将患者分为低血糖组18例和无低血糖组22例。进一步根据发生低血糖次数将低血糖患者分为多发组8例和少发组10例。统计低血糖发生率及原因。比较各组性别、年龄、糖尿病病程、收缩压、舒张压、糖化血红蛋白、三酰甘油、低密度脂蛋白胆固醇水平。结果低血糖发生18例(占45.00%),低血糖发生次数83次,餐后低血糖发生次数49次(占59.04%),夜间低血糖发生次数34次(占40.96%)。餐后低血糖主要原因是鼻饲反流。夜间低血糖主要原因是睡前血糖偏低及胰岛素剂型。少发组的糖尿病病程短于多发组,糖化血红蛋白水平高于多发组,差异有统计学意义(P<0.05)。结论病程越长、血糖控制越严格的糖尿病合并持续植物状态胰岛素注射患者更易发生低血糖,临床需关注鼻饲反流和胰岛素剂型。Objective To investigate occurrence and causes of hypoglycemia in insulin-injecting diabetic patients with persistent vegetative state. Methods A total of 40 patients with diabetes mellitus complicated with persistent vegetative state insulin intradermal injection to control blood sugar were selected from February 2017 to March 2018 in Three Departments of Cadre Ward, the Seventh Medical Center in PLA General Hospital. Blood sugar was monitored. According to occurrence of hypoglycemia, the patients were divided into hypoglycemia group (18 cases) and non-hypoglycemia group (22 cases). According to the frequency of hypoglycemia, hypoglycemia patients were divided into multiple-occurrence group (8 cases) and low-occurrence group (10 cases). The incidence and causes of hypoglycemia were counted. Gender, age, course of diabetes, systolic blood pressure, diastolic blood pressure, glycosylated hemoglobin, triglyceride and low density lipoprotein cholesterol were compared among groups. Results There were 18 cases of hypoglycemia (45.00%), 83 times of hypoglycemia, 49 times of postprandial hypoglycemia (59.04%) and 34 times of night hypoglycemia (40.96%). The main cause of postprandial hypoglycemia was nasal feeding reflux. The main causes of night hypoglycemia were hypoglycemia before bed and insulin dosage forms. The course of diabetes mellitus in low-occurrence group was shorter than that in multiple-occurrence group, and the level of glycosylated hemoglobin was higher than that in multiple-occurrence group (P < 0.05). Conclusion Insulin-injecting diabetic patients with persistent vegetative state are more likely to suffer from hypoglycemia with longer course of disease and stricter blood sugar control. Clinical attention should be paid to nasal feeding reflux and insulin dosage form.

关 键 词：糖尿病 持续植物状态 低血糖 胰岛素注射 

分 类 号：R587.1[医药卫生—内分泌]