2型糖尿病合并脓毒症患者采用不同胰岛素强化治疗方案的临床效果对比  

Comparison of Clinical Effects of Different Insulin Intensive Treatment Regimens in Patients with Type 2 Diabetes Mellitus Complicated with Sep⁃sis

作　　者：王汝鹏 陈燕瑜 蔡燕清 WANG Rupeng;CHEN Yanyu;CAI Yanqing(Department of Intensive Care Medicine,Shishi Hospital,Shishi 362700,Fujian,China)

机构地区：[1]石狮市医院重症医学科,福建石狮362700

出　　处：《糖尿病新世界》2024年第21期56-59,共4页Diabetes New World

摘　　要：目的探究采用不同胰岛素强化治疗2型糖尿病合并脓毒症患者的效果。方法回顾性选取2023年2月—2024年3月石狮市医院收治的60例2型糖尿病合并脓毒症患者的临床资料,按照治疗方式的不同分为两组,各30例。对照组采用门冬胰岛素治疗,观察组采用门冬胰岛素联合甘精胰岛素治疗。对比两组糖代谢指标、体重指数、血糖变异性、临床观察指标。结果治疗后,两组空腹血糖、餐后2 h血糖、糖化血红蛋白、体重指数比较,差异均无统计学意义(P均>0.05)。观察组最大血糖幅度、24 h平均血糖波动幅度、血糖变异系数、空腹血糖变异系数均低于对照组,差异均有统计学意义(P均<0.05)。观察组血糖达标时间、体温异常缓解时间、白细胞异常缓解时间、抗生素应用时间均短于对照组,胰岛素应用剂量少于对照组,C反应蛋白下降程度高于对照组,差异均有统计学意义(P均<0.05)。结论不同胰岛素强化治疗在2型糖尿病合并脓毒症患者中均具有一定的效果,但门冬胰岛素联合甘精胰岛素方案可以改善患者的血糖变异性,缩短血糖达标时间,减少胰岛素的应用剂量。Objective To explore the effect of different insulin intensive treatment on patients with type 2 diabetes mellitus complicated with sepsis.Methods The clinical data of 60 patients with type 2 diabetes mellitus complicated with sepsis admitted to Shishi Hospital from February 2023 to March 2024 were retrospectively selected and divided into two groups according to different treatment methods,with 30 cases in each group.The control group was treated with insulin aspart,and the observation group was treated with insulin aspart combined with insulin glargine.The glu-cose metabolism indexes,body mass index,blood glucose variability and clinical observation indexes were compared between the two groups.Results After treatment,there were no statistically significant differences in fasting blood glu-cose,2-hour postprandial blood glucose,glycated hemoglobin A1c and body mass index between the two groups(all P>0.05).The maximum blood glucose amplitude,24 h average blood glucose fluctuation amplitude,coefficient of varia-tion of blood glucose and coefficient of variation of fasting blood glucose in the observation group were lower than those in the control group,and the differences were statistically significant(all P<0.05).The time of blood glucose reaching the standard,the time of abnormal body temperature remission,the time of abnormal white blood cell remis-sion,and the time of antibiotic application in the observation group were shorter than those in the control group,the dose of insulin was less than that in the control group,and the decrease degree of C-reactive protein was higher than that in the control group,and the differences were statistically significant(all P<0.05).Conclusion Different intensive insulin therapies have a certain effect in patients with type 2 diabetes mellitus complicated with sepsis,but insulin as-part combined with insulin glargine can improve the blood glucose variability of patients,shorten the time of blood glu-cose reaching the target,and reduce the application dose of insulin.

关 键 词：2型糖尿病 脓毒症 治疗效果 

分 类 号：R587.2[医药卫生—内分泌]