持续静滴胰岛素与胰岛素泵治疗糖尿病酮症酸中毒的效果与氧化应激水平对比  

Comparison of the Effect of Continuous Intravenous Insulin Infusion and Insulin Pump in the Treatment of Diabetic Ketoacidosis and the Level of Oxidative Stress

作　　者：郑金清 杨小兰[1] 李正明 李榕华 ZHENG Jinqing;YANG Xiaolan;LI Zhengming;LI Ronghua(Emergency Department,the Second Hospital of Longyan City,Longyan,Fujian Province,364000 China)

机构地区：[1]福建省龙岩市第二医院急诊科,福建龙岩364000

出　　处：《糖尿病新世界》2022年第19期23-26,共4页Diabetes New World Magazine

摘　　要：目的 探讨持续静滴胰岛素与胰岛素泵治疗糖尿病酮症酸中毒(diabetes ketoacidosis,DKA)的效果与氧化应激水平对比。方法 选取福建省龙岩市第二医院2020年2月—2022年2月接诊的86例DKA患者为研究对象,按随机数表法将其分为观察组(n=43)、对照组(n=43)。观察组予以胰岛素泵治疗,对照组予以持续静滴胰岛素治疗,对比两组临床治疗指标(尿酮转阴时间、血糖达标时间、血浆pH值恢复正常时间、胰岛素应用剂量);对比两组氧化应激指标[丙二醛(MDA)、过氧化氢酶(CAT)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GPX)];对比两组糖尿病特异性生存质量量表(DQOL)评分。结果 观察组尿酮转阴时间、血糖达标时间与血浆pH值恢复正常时间均较对照组短,胰岛素应用剂量较对照组低,MDA水平与DQOL评分均较对照组低,CAT、SOD、GPX水平均较对照组高,差异有统计学意义(P<0.05)。结论 与持续静滴胰岛素相比,胰岛素泵治疗DKA效果更为显著,该给药方式不仅能快速改善酮症酸中毒,稳控血糖,减少胰岛素使用量,还能改善患者的氧化应激水平,提高其生活质量。Objective To investigate the effect and oxidative stress level of continuous intravenous insulin infusion and insulin pump in the treatment of diabetic ketoacidosis(DKA).Methods A total of 86 DKA patients admitted to Fujian Longyan Second Hospital from February 2020 to February 2022 were selected as observation objects.According to the random number table method,they were divided into observation group(n=43)and control group(n=43).The observation group was given insulin pump therapy,and the control group was given continuous intravenous insulin therapy.The clinical treatment indicators(time to negative urine ketone,time to blood glucose reaching the standard,time for plasma pH to return to normal,and dose of insulin)were compared between the two groups.The two groups of oxidative stress indicators[malondialdehyde(MDA),catalase(CAT),superoxide dismutase(SOD),glutathione peroxidase(GPX)]were compared.The diabetes-specific quality of life(DQOL)scores were compared between the two groups.Results The time for urine ketone to turn negative,the time for blood glucose to reach the standard and the time for plasma pH to return to normal in the observation group were shorter than those in the control group,and the dose of insulin applied was lower than that of the control group,and the MDA level and DQOL score were lower than those of the control group,and the levels of CAT,SOD and GPX were higher than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Compared with continuous intravenous infusion of insulin, the effect of insulin pump in the treatment of DKA is more significant. This method of administrationcan not only rapidly improve ketoacidosis, stabilize blood glucose, and reduce the amount of insulin used. It can alsoimprove oxidative stress levels in patients and improve their quality of life.

关 键 词：持续静滴 胰岛素 胰岛素泵 糖尿病酮症酸中毒 氧化应激 

分 类 号：R587[医药卫生—内分泌]