胰岛素应用方式与监测频率对儿童1型糖尿病并发症的预测意义  

Predictive significance of application mode and monitoring frequency of insulin for complications of type 1 diabetes mellitus in children

作　　者：郑彬 邵成良 张驰[2] ZHENG Bin;SHAO Cheng-Liang;ZHANG Chi(The First People’s Hospital of Fuyang District,Hangzhou,Zhejiang 311400,China;不详)

机构地区：[1]杭州市富阳区第一人民医院,浙江杭州311400 [2]温州医科大学,浙江温州325035

出　　处：《中国妇幼保健》2020年第24期4755-4758,共4页Maternal and Child Health Care of China

基　　金：浙江省医药卫生计划项目(2015KYB236 FGF21)。

摘　　要：目的探讨多次胰岛素注射(MDI)、持续皮下胰岛素输注(CSⅡ)联合持续动态血糖监测(CGMS)对儿童1型糖尿病(T1DM)并发症的预测意义。方法选取2017年2月-2018年2月在基层儿童青少年糖尿病慢病管理中心接受治疗的105例T1DM患儿根据随访1年后并发症发生情况将其分为无并发症组47例和并发症组58例。其中53例患儿应用MDI治疗,52例患儿应用CSⅡ治疗,随访期间分别观察MDI、CSⅡ治疗患儿低血糖发生情况。患儿分别于入组及随访3、6、9、12个月时采用德国罗氏卓越血糖仪测定空腹血糖(FPG)、餐后2 h血糖(2hPG),采用西门子糖化血红蛋白分析仪测定糖化血红蛋白(HbA1c)。结果并发症组患儿MDI构成比显著高于无并发症组,CSⅡ联合CGMS构成比明显低于无并发症组,差异均有统计学意义(P<0.05)。随访期间并发症组患儿MDI、CSⅡ联合CGMS低血糖发生次数均显著多于无并发症组,且并发症组患儿CSⅡ联合CGMS低血糖发生次数明显少于MDI低血糖发生次数,差异均有统计学意义(P<0.05)。两组CSⅡ联合CGMS治疗患儿入组时FPG、2hPG水平及HbA1c相比差异均无统计学意义(P>0.05);随着时间延长,两组CSⅡ联合CGMS治疗患儿FPG、2hPG水平及HbA1c均逐渐降低,且并发症组CSⅡ联合CGMS治疗患儿在随访3、6、9、12个月时FPG、2hPG水平及HbA1c均明显高于无并发症组患儿,差异均有统计学意义(P<0.05)。结论CSⅡ联合CGMS治疗更有利于早期预测儿童T1DM并发症发生情况,以期为儿童T1DM并发症的防治提供依据。Objective To explore the predictive significance of multiple insulin injection(MDI),continuous subcutaneous insulin infusion(CSⅡ)combined with continuous dynamic glucose monitoring(CGMS)for complications of type 1 diabetes mellitus(T1DM)in children.Methods From February 2017 to February 2018,105 children with T1DM treated in primary management center of children and adolescents with chronic diabetes mellitus were selected and divided into non-complication group(47 children)and complication group(58 children)according to occurrence of complications or not after one year of follow-up,53 children were treated by MDI,and 52 children were treated by CSⅡ.During follow-up,the incidence rates of hypoglycemia in children treated by MDI and CSⅡwere observed,respectively.Fasting plasma glucose(FPG)and 2-hour postprandial blood glucose(2hPG)were detected at admission and at 3,6,9,and 12 months during follow-up,the level of glycosylated hemoglobin was detected.Results The proportion of MDI in complication group was statistically significantly higher than that in non-complication group,the proportion of CSⅡcombined with CGMS in complication group was statistically significantly lower than that in non-complication group(P<0.05).During follow-up period,the incidence rates of hypoglycemia induced by MDI and CSⅡcombined with CGMS in complication group were statistically significantly higher than those in non-complication group,the incidence rate of hypoglycemia induced by CSⅡcombined with CGMS in complication group was statistically significantly less than that induced by MDI(P<0.05).There was no statistically significant difference in FPG,2hPG,and HbA1c levels of children treated by CSⅡcombined with CGMS between the two groups(P>0.05).FPG,2hPG,and HbA1c levels of children treated by CSⅡcombined with CGMS in the two groups decreased gradually with time.FPG,2hPG,and HbA1c levels of children treated by CSⅡcombined with CGMS at 3,6,9,and 12 months during follow-up in complication group were statistically significant

关 键 词：1型糖尿病 多次胰岛素注射 持续皮下胰岛素输注 持续动态血糖监测 儿童 

分 类 号：R725.8[医药卫生—儿科]