胰岛素治疗小儿糖尿病的效果及血糖指标分析  

Analysis of the effect of insulin on the treatment of infantile diabetes and blood glucose index

作　　者：邱彬玮 钱小芳 张瑶 张丽萍 QIU Binwei;QIAN Xiaofang;ZHANG Yao;ZHANG Liping(Department of Pediatrics,Longyan First Hospital Affiliated to Fujian Medical University,Longyan,Fujian Province,364000 China)

机构地区：[1]福建医科大学附属龙岩第一医院儿科,福建龙岩364000

出　　处：《糖尿病新世界》2022年第1期18-21,30,共5页Diabetes New World Magazine

摘　　要：目的探讨胰岛素治疗小儿1型糖尿病(T1DM)是的效果及血糖指标分析。方法选取该院在2019年3月—2020年3月确诊并治疗的66例T1DM患儿,采用随机数字表法分组,对照组应用每日多次皮下胰岛素注射(MDI)治疗,研究组使用胰岛素泵持续皮下胰岛素输注(CSII)治疗。观察比较两组的血糖控制指标情况;两组随访3个月、6个月的HbA1c水平及差异;两组治疗前、治疗后的相关生存质量(PedsQL)量表指标水平及差异;两组发生低血糖的情况。结果研究组治疗后的HbA1c水平为(8.4±1.3)%,比对照组治疗后的HbA1c水平(9.8±2.3)%显著更低,差异有统计学意义(t=18.694,P<0.05);研究组血糖达标耗时为(4.3±2.4)d,比对照组的血糖达标耗时(6.8±2.1)d更短,差异有统计学意义(t=16.457,P<0.05)。研究组随访3个月、6个月的HbA1c水平分别为(8.3±1.4)%、(8.1±1.4)%,比对照组随访3个月、6个月的HbA1c水平(9.7±2.2)%、(8.9±2.4)%显著更低,差异有统计学意义(t=17.452、18.021,P<0.05)。研究组治疗后患儿的各项生存质量指标评分分别为症状(28.4±2.5)分、治疗障碍(10.2±1.2)分、依从性(9.5±1.4)分、担忧(8.3±1.4)分、交流(6.2±2.1)分、总分(60.3±3.3)分,比对照组患儿的各项生存质量指标评分:症状(31.4±3.2)分、治疗障碍(13.1±2.1)分、依从性(11.1±1.6)分、担忧(10.5±1.7)分、交流(7.9±2.1)分、总分(75.2±5.9)分显著更低,差异有统计学意义(t=16.582、17.635、16.152、19.845、17.032、17.984,P<0.05)。研究组治疗后患儿父母的各项生存质量指标评分分别为体力(18.2±2.6)分、情绪(8.2±2.3)分、社会(10.1±1.6)分、学校(9.8±1.8)分、治疗(10.2±2.1)分、总分(56.9±2.2)分,比对照组患儿父母的各项生存质量指标评分:体力(21.2±3.2)分、情绪(10.9±3.5)分、社会(12.7±2.3)分、学校(12.2±2.1)分、治疗(12.5±2.6)分、总分(68.5±2.6)分显著更低,差异有统计学意义(t=8.152、19.032、17.452、19.021、17.452、19.3Objective To investigate the effect of insulin in treating children with type 1 diabetes(T1 DM) and analysis of blood glucose indicators. Methods A total of 66 children with T1 DM who were diagnosed and treated in the hospital from March 2019 to March 2020 were selected and according to the randomly number table method divided into groups. The control group was treated with multiple subcutaneous insulin injections(MDI) every day.The study group was treated with continuous subcutaneous insulin infusion(CSII) with an insulin pump. Observed and compared the blood glucose control indicators of the two groups. The HbA1c levels and differences between the two groups were followed up for 3 months and 6 months. The levels and differences of related quality of life(PedsQL) scale indicators before and after treatment, hypoglycemia occurred in the two groups were observed and compared. Results The level of HbA1c in the study group was(8.4±1.3) % after treatment, which was lower than that in the control group(9.8±2.3) % after treatment, and the difference was statistically significant(t=18.694, P<0.05). The time of blood glucose reaching standard in the study group was(4.3±2.4) d, which was shorter than that in the control group(6.8±2.1) d, and the difference was statistically significant(t=16.457, P<0.05). The HbA1 c levels of the study group were(8.3±1.4) % and(8.1±1.4) % at 3 and 6 months follow-up respectively, which were lower than the HbA1 c levels of the control group(9.7±2.2) % and(8.9±2.4) % at 3 and 6 months follow-up respectively, and the difference was statistically significant(t=17.452, 18.021, P<0.05). The quality of life index scores of the children in the study group after treatment were as follows: symptoms(28.4±2.5) points, treatment barriers(10.2±1.2) points,compliance(9.5 ±1.4) points, worry(8.3 ±1.4) points, communication(6.2 ±2.1) points, total score(60.3 ±3.3) points,compared with the control group of children’s quality of life index scores: symptom(31.4 ±3.2)points, treatment barrier(

关 键 词：胰岛素 1型糖尿病 CSII MDI HBA1C 

分 类 号：R59[医药卫生—内科学]