不同C肽水平T2DM老年患者CSII强化治疗的基础-餐前剂量特点分析  

Analysis of basal-preprandial dose characteristics of CSII intensive treatment in elderly T2DM patients with different C-P levels

作　　者：董银樵 顾秀云 曹顺民 DONG Yinqiao;GU Xiuyun;CAO Shunmin(Department of Clinical Laboratory,Tianchang City People􀆳s Hospital,Tianchang 239300,Anhui,China)

机构地区：[1]天长市人民医院检验科,安徽天长239300

出　　处：《中南医学科学杂志》2023年第2期288-291,共4页Medical Science Journal of Central South China

摘　　要：目的 分析不同C肽水平2型糖尿病(T2DM)老年患者连续皮下胰岛素输注(CSII)强化治疗时基础-餐前剂量特点。方法 选取行CSII强化治疗的T2DM患者116例,将受试者按餐后2小时C肽与空腹C肽比值(C_(2h)/C_(0))大小分为高C肽比值组(C_(2h)/C_(0)≥2.5)和低C肽比值组(C_(2h)/C_(0)<2.5)。比较两组患者的胰岛素基础量与餐前量的差异,并总结其特点。结果 116例患者平均胰岛素用量为(0.5±0.1)U/kg,高C肽比值组51例,低C肽比值组65例,高C肽比值组空腹血糖(FBG)、餐后2 h血糖(2 hPBG)、体质指数、糖化血红蛋白(HbA1c)CSII 24小时基础率胰岛素基础量/总量均低于低C肽比值组(P<0.05);Pearson直线相关分析显示基础量占胰岛素总量百分比与体质指数呈正相关(r=0.369,P<0.05),与C_(2h)/C_(0)比值呈负相关(r=-0.345,P<0.05)。结论 T2DM老年患者在接受CSII强化治疗时胰岛功能较差者需提高基础剂量至50%左右,同时设定总量时需考虑肥胖等的影响。Aim To analyze the characteristics of basic pre meal dose in elderly patients with type 2 diabetes mellitus(T2DM)with different levels of C-Peptide(C-P)when receiving intensive treatment with continuous subcutaneous insulin infusion(CSII).Methods 116 patients with T2DM who were hospitalized in the Department of Endocrinology and received CSII intensive treatment were selected.They were divided into high C-peptide ratio group(C_(2h)/C_(0)≥2.5)and low C-peptide ratio group(C_(2h)/C_(0)<2.5)according to the ratio of C-peptide to fasting C-peptide at 2h postprandial(C_(2h)/C_(0)).Compare the difference between the basic amount and the premeal amount,and summarize the characteristics of insulin dosage.Results The average dosage of insulin in 116 patients was(0.5±0.1)U/kg.In addition,C_(2h)/C_(0)≥2.5 in 51 cases(high C peptide ratio group),and C_(2h)/C_(0)<2.5 in 65 cases(low C peptide ratio group);FBG,2 hPBG,body mass index and HbA1c in high C-peptide ratio group were lower than those in the low C-peptide ratio group(P<0.05),CSII 24-hour basal rate and percentage of basal dose in total insulin in high C-peptide ratio group were significantly lower than those in low C-peptide ratio group(P<0.05);Pearson linear correlation analysis showed that the percentage of basal amount in total insulin was positively correlated with body mass index(r=0.369,P<0.05),and negatively correlated with C_(2h)/C_(0) ratio(r=-0.345,P<0.05).Conclusion Elderly T2DM patients with poor islet function in intensive CSII treatment need to increase the basal dose to about 50%,and the influence of obesity and other factors should be considered when setting the total amount.

关 键 词：C肽 老年 2型糖尿病 CSII 胰岛素剂量 

分 类 号：R587.1[医药卫生—内分泌]