胰岛素联合平衡盐溶液对重度DKA患者的影响  

Effects of insulin combined with balanced salt solution on patients with severe DKA

作　　者：陈乃君 高倩 CHEN Naijun;GAO Qian(Department of Endocrinology,the Affiliated Hospital of Shaoxing University of Arts and Sciences,Zhejiang,Shaoxing 312000,China)

机构地区：[1]绍兴文理学院附属医院内分泌科,浙江绍兴312000

出　　处：《中国现代医生》2022年第26期18-22,共5页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2018KY838)。

摘　　要：目的研究胰岛素联合平衡盐溶液对重度糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)患者的影响。方法选取2018年6月至2021年6月在绍兴文理学院附属医院治疗的重度DKA患者60例,采用数表法随机分为胰岛素组和溶液联合组,每组各30例,胰岛素组使用胰岛素治疗,溶液联合组联合应用胰岛素与平衡盐溶液治疗。采用酶联免疫吸附法检测β2微球蛋白、肌酐、尿素氮、丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、总抗氧化能力(total antioxidant capacity,TAOC)、游离三碘甲状腺原氨酸(free triiodothyronine,FT3)、游离甲状腺素(freethyroxine,FT4);评价患者临床疗效与不良反应。结果与胰岛素组相比,溶液联合组β2微球蛋白、肌酐、尿素氮、MDA水平均显著降低,差异均有统计学意义(P<0.05)。与胰岛素组相比,溶液联合组SOD、TAOC、FT3、FT4水平均显著升高,差异均有统计学意义(P<0.05)。与胰岛素组相比,溶液联合组治疗重度DKA总有效率较高,差异有统计学意义(P<0.05)。结论使用胰岛素联合平衡盐溶液治疗可有效改善患者临床症状,改善β2微球蛋白、TAOC、FT4水平,利于患者预后。Objective To study the effect of insulin combined with balanced salt solution in patients with severe diabetic ketoacidosis(DKA).Methods A total of 60 patients with severe DKA who were treated in the Affiliated Hospital of Shaoxing University of Arts and Sciences from June 2018 to June 2021 were selected and divided into the insulin group and the solution combination group,with 30 cases in each group.The insulin group was treated with insulin,and the solution combination group with insulin treat with a balanced salt solution.Enzyme-linked immunosorbent assay was used to detectβ2 microglobulin,creatinine,urea nitrogen,malondialdehyde(MDA),superoxide dismutase(SOD),total antioxidant capacity(TAOC),free triiodothyronine(FT3),free thyroxine(FT4);and evaluate the clinical efficacy and adverse reactions of patients.Results Compared with the insulin group,the levels ofβ2 microglobulin,creatinine,blood urea nitrogen,MDA,and MDA in the solution combination group were significantly decreased,and all differences were statistically significant(P<0.05).Compared with the insulin group,the SOD,TAOC,FT3 and FT4 levels in the solution combination group were significantly increased,all differences were statistically significant(P<0.05).Compared with the insulin group,the total effective rate of the solution combination group in the treatment of severe DKA was higher,and the difference was statistically significant(P<0.05).Conclusion The study found that the use of insulin combined with balanced salt solution treatment can effectively improve the clinical symptoms of patients,improve the levels ofβ2 microglobulin,TAOC,and FT4,which is beneficial to the prognosis.

关 键 词：胰岛素 平衡盐溶液 糖尿病酮症酸中毒 Β2微球蛋白 总抗氧化能力 游离甲状腺素 

分 类 号：R587.2[医药卫生—内分泌]