动态血糖监测结合CSII治疗老年脆性糖尿病的临床疗效  

Effect Analysis of Dynamic Blood Glucose Monitoring Combined with CSII in the Treatment of Elderly Brittle Diabetes Mellitus

作　　者：何秋芬 李华 燕歌 HE Qiu-fen;LI Hua;YAN Ge(Department of Endocrinology,Zhabei Central Hospital of Jing'an Districts Shanghai 200070,China)

机构地区：[1]上海市静安区闸北中心医院内分泌科,上海200070

出　　处：《医学临床研究》2021年第5期747-749,753,共4页Journal of Clinical Research

摘　　要：【目的】探讨动态血糖监测结合持续皮下胰岛素注射(CSII)治疗老年脆性糖尿病的临床疗效。【方法】收集2018年9月至2020年9月在本院诊治的94例老年脆性糖尿病患者,按照随机数表法分为对照组和观察组,每组47例。所有患者均采用CSII控制血糖,同时对照组予以八段指尖血糖监测,观察组予以动态血糖监测。比较两组患者临床疗效、血糖达标情况(血糖达标时间、胰岛素用量)、低血糖发生率及治疗前后血糖稳态指标[血糖水平标准差(SDBG)、最大血糖波动幅度(LAGE)、日间血糖平均绝对差(MODD)、空腹血糖变异系数(FPG-CV)、餐后血糖波动幅度(PPGE)]。【结果】治疗7 d后,观察组总有效率为97.87%(46/47),显著高于对照组的78.72%(37/47),其差异有统计学意义(χ^(2)=8.340,P=0.004);观察组患者血糖达标时间、胰岛素用量分别为(3.53±1.14)(1、(32.83±3.56)U/d,均显著低于对照组的(6.39±1.35)d、(41.02±3.76)U/d,其差异均有统计学意义(t=11.097、10.844,P<0.05);治疗7 d后,两组患者SDBG、LAGE、MODD、FPG-CV、PPGE均较治疗前降低,且观察组低于对照组,其差异均有统计学意义(均P<0.05);观察组低血糖事件、无感知低血糖事件发生率分别为(2.02±0.65)次/人、(0.54±0.19)次/人,均显著少于对照组的(4.31±1.09)次/人、(1.70±0.53)次/人,其差异均有统计学意义(t=12.371、14.125,P<0.05)。【结论】动态血糖监测结合CSII治疗老年脆性糖尿病疗效确切,可改善血糖波动,减少低血糖事件,值得临床推广应用。[Objective]To analyze the effect of dynamic blood glucose monitoring combined with continu-ous subcutaneous insulin injection(CSII)in the treatment of elderly brittle diabetes mellitus.【Methods】A total of 94 elderly patients with brittle diabetes mellitus in our hospital were enrolled between September 2018 and September 2020.They were randomly divided into the control group and the observation group with 47 cases in each group by the random number table method.All patients were treated with CSII to control blood glucose.On this basis,patients in the control group received eight-stage fingertip blood glucose monitoring while patients in the observation group received dynamic blood glucose monitoring.The clinical efficacy^blood glucose compliance(time of blood glucose compliance,insulin dosage),blood glucose steady-state indicators before treatment and after 7 d of treatment[standard deviation of blood glucose(SDBG),largest amplitude of glycemic excursions(LAGE),mean of daily differences(MODD),fasting plasma glucose coefficient of variation(FPG-CV),postprandial glucose excursion(PPGE)]and occurrence of hypoglycemia were compared be-tween the two groups.【Results】After 7 days of treatment,the total effective rate was 97.87%(46/47)and 78.72%(37/47),respectively,in the observation group and in the control group.The total effective rate of treatment in observation group was higher than that in control group(P<0.05)and the difference was statistically significant(χ^(2)=8.340,P=0.004).The time of blood glucose compliance and insulin dosage in observation group were 3.53±1.14 d and 32.83zb3.56 U/d,respectively,which were lower than those in control group(6.39±1.35 d and 41.02±3.76,respectively).The differences were statistically significant(t=11.097,10.844,P<0.05).The SDBG,LAGE,MODD,FPG-CV and PPGE after 7 d of treatment in the two groups were decreased compared to those before treatment,and the above indexes of observation group were lower than those of control group(P<0.05).The incidence rates of hypoglycemi

关 键 词：糖尿病/治疗 血糖/分析 胰岛素/投药和剂量 老年人 

分 类 号：R587.1[医药卫生—内分泌]