胰岛素泵治疗儿童1型糖尿病疗效观察  

Therapy effect of continuous subcutaneous insulin infusion for children with type 1 diabetes mellitus

作　　者：李桂梅[1] 薛江[2] 马沛然[1] 尹洪臣[1] 陈力军[1] 高飞[1] 蒋莎义[1] 欧阳士香[1] 

机构地区：[1]山东省立医院,山东济南250021 [2]山东大学医学院

出　　处：《山东医药》2003年第31期9-10,共2页Shandong Medical Journal

基　　金：山东省科学技术委员会科研奖励基金(No.9835)

摘　　要：目的 观察胰岛素泵持续皮下输注短效胰岛素(CSII)对儿童1型糖尿病(T_1DM)的治疗效果。方法 ①胰岛素泵持续皮下输注CSII治疗6例传统胰岛素治疗(CIT)血糖控制不满意的T_1DM患儿,并比较其用泵前后空腹血糖(FBG)、餐后2小时血糖(2hPBG)、糖化血红蛋白(HbA_(1c))、胰岛素(INS)用量、胆固醇(CH)及甘油三酯(TG)的变化;②治疗组用泵后上述代谢指标与33例正常对照组比较。结果 ①治疗组用泵后FBG、2hPBG、HbA_(1c)、INS用量、TG均较用泵前显著降低;用泵后INS用量减少16％;用泵后患儿依从性增高。②治疗组用泵后FBG、CH及TG均较正常对照组无差异,2hPBG、HbA_(1c)仍显著高于正常对照,但均达到强化治疗目的。结论 ①CSII治疗儿童T_1DM可显著改善其代谢指标,使血糖和血脂降至正常和接近正常。②CSII治疗儿童通过改善HbA_(1c)及血脂T_1DM,可延缓其慢性并发症的发生。Objective To assess the therapy effect of continuous subcutaneous insulin infusion (CSII) for patients with type 1 diabetes mellitus (T1DM). Methods ①Indexes of fasting blood glucose (FBG), 2-hour postprandial blood glucose (2hPBG) ,glycosylated haemoglobin (HbAlc) .cholesterol (CH)and triglycerides (TG) were examined in 6 pediatric patients with T1DM treated with CSII using rapid-acting insulin(RI) analogues (CSII group) and 33 healthy children (control group). ②Metabolic indexes mentioned above and RI dose were compared in the year during pump use with the year prior to CSII (pre CSII group) and the metabolic indexes were compared in CSII group with control group-Results ① FBG. 2hPBG. HbA1c , TG and insulin dose decreased significantly in CSII group when compared with pre CSII groupjand the compliance was better after pump use. ② There were no significant differences about FBG,CH and TG between CSII group and control group. There were significant differences about 2hPBG and HbA1C between CSII group and control group, but reach the aim of intensive therapy. Conclusions ①CSII can be used safely in children patients with T1DM to improve metabolic control and compliance. ② CSII can prevent or postpone the chronic complication because of decreased metabolic indexes.

关 键 词：胰岛素泵 治疗 儿童 1型糖尿病 皮下输注 短效胰岛素 

分 类 号：R725.871[医药卫生—儿科] R977.15[医药卫生—临床医学]