中国循环杂志
中國循環雜誌
중국순배잡지
CHINESE CIRCULATION JOURNAL
2014年
7期
520-524
,共5页
李肖珏%陈燕燕%巩秋红%安雅莉%张丽红%回园敕%沈晓霞%冯新星%王慧%李光伟
李肖玨%陳燕燕%鞏鞦紅%安雅莉%張麗紅%迴園敕%瀋曉霞%馮新星%王慧%李光偉
리초각%진연연%공추홍%안아리%장려홍%회완칙%침효하%풍신성%왕혜%리광위
2型糖尿病%心脏病%连续皮下胰岛素输注
2型糖尿病%心髒病%連續皮下胰島素輸註
2형당뇨병%심장병%련속피하이도소수주
Type 2 diabetes%Heart disease%Continuous subcutaneous insulin infusion
目的：评估14天胰岛素泵强化治疗合并心脏病的2型糖尿病（病程小于5年）的疗效及安全性。<br> 方法：既往有心脏病史的2型糖尿病患者22例，平均年龄（48.15±9.80）岁，男女比例20：2。既往未行系统降糖治疗，入院后给予14天胰岛素泵强化降糖治疗，比较治疗前后的血糖水平、胰岛功能、胰岛素敏感性。<br> 结果：胰岛素泵强化治疗后，血糖水平显著下降，空腹血糖及馒头餐试验30、60、120分钟血糖差异均有统计学意义（P<0.001）；60分钟、120分钟C肽水平提高[2.73（1.05~7.05）ng/ml vs 3.84（1.22~63.39）ng/ml，3.34（1.42~9.61） ng/ml vs 6.27（0.93~47.39）ng/ml，P均=0.004]；胰岛素敏感性（IAI）改善（-1.89±0.29 vs -1.70±0.31，P=0.008）。治疗后仅依靠饮食控制和规律运动血糖即可达标者5例（22.73%），继续使用降糖药物治疗者17例（77.27%）；平均随访（12.4±8.5）个月（1~28个月），5例停泵患者仍有4例未用任何降糖药物治疗，血糖控制良好，另1例因饮食控制差，血糖升高，2个月后行胰岛素治疗，余17例维持口服降糖药物治疗。<br> 结论：合并心脏病的2型糖尿病患者可行短期的胰岛素泵强化降糖治疗。该治疗方式可快速解除高糖毒性，改善胰岛素敏感性。部分患者停用降糖药物，减轻其过多的用药负担。
目的：評估14天胰島素泵彊化治療閤併心髒病的2型糖尿病（病程小于5年）的療效及安全性。<br> 方法：既往有心髒病史的2型糖尿病患者22例，平均年齡（48.15±9.80）歲，男女比例20：2。既往未行繫統降糖治療，入院後給予14天胰島素泵彊化降糖治療，比較治療前後的血糖水平、胰島功能、胰島素敏感性。<br> 結果：胰島素泵彊化治療後，血糖水平顯著下降，空腹血糖及饅頭餐試驗30、60、120分鐘血糖差異均有統計學意義（P<0.001）；60分鐘、120分鐘C肽水平提高[2.73（1.05~7.05）ng/ml vs 3.84（1.22~63.39）ng/ml，3.34（1.42~9.61） ng/ml vs 6.27（0.93~47.39）ng/ml，P均=0.004]；胰島素敏感性（IAI）改善（-1.89±0.29 vs -1.70±0.31，P=0.008）。治療後僅依靠飲食控製和規律運動血糖即可達標者5例（22.73%），繼續使用降糖藥物治療者17例（77.27%）；平均隨訪（12.4±8.5）箇月（1~28箇月），5例停泵患者仍有4例未用任何降糖藥物治療，血糖控製良好，另1例因飲食控製差，血糖升高，2箇月後行胰島素治療，餘17例維持口服降糖藥物治療。<br> 結論：閤併心髒病的2型糖尿病患者可行短期的胰島素泵彊化降糖治療。該治療方式可快速解除高糖毒性，改善胰島素敏感性。部分患者停用降糖藥物，減輕其過多的用藥負擔。
목적：평고14천이도소빙강화치료합병심장병적2형당뇨병（병정소우5년）적료효급안전성。<br> 방법：기왕유심장병사적2형당뇨병환자22례，평균년령（48.15±9.80）세，남녀비례20：2。기왕미행계통강당치료，입원후급여14천이도소빙강화강당치료，비교치료전후적혈당수평、이도공능、이도소민감성。<br> 결과：이도소빙강화치료후，혈당수평현저하강，공복혈당급만두찬시험30、60、120분종혈당차이균유통계학의의（P<0.001）；60분종、120분종C태수평제고[2.73（1.05~7.05）ng/ml vs 3.84（1.22~63.39）ng/ml，3.34（1.42~9.61） ng/ml vs 6.27（0.93~47.39）ng/ml，P균=0.004]；이도소민감성（IAI）개선（-1.89±0.29 vs -1.70±0.31，P=0.008）。치료후부의고음식공제화규률운동혈당즉가체표자5례（22.73%），계속사용강당약물치료자17례（77.27%）；평균수방（12.4±8.5）개월（1~28개월），5례정빙환자잉유4례미용임하강당약물치료，혈당공제량호，령1례인음식공제차，혈당승고，2개월후행이도소치료，여17례유지구복강당약물치료。<br> 결론：합병심장병적2형당뇨병환자가행단기적이도소빙강화강당치료。해치료방식가쾌속해제고당독성，개선이도소민감성。부분환자정용강당약물，감경기과다적용약부담。
Objectives: To evaluate the effect and safety of 14-day continuous subcutaneous insulin infusion (CSII) in type 2 diabetes patients with heart diseases. <br> Methods: A total of 22 consecutive type 2 diabetes patients (history ≤ 5 years) with heart diseases treated in our hospital from 2011-03 to 2013-08 were studied. There were 20 male, and the with the mean age of patieuts (48.15 ± 9.80) years, all patients without standard hypoglycemic treatment before admission. The patients received 14-day CSII for enhanced treatment and the blood glucose level, insulin function and insulin sensitivity were compared before and after the treatment. <br> Results: After CSII treatment, the blood glucose level was obviously decreased, fasting blood glucose (FBG) and postprandial blood glucose at 30, 60 and 120 min were improved, all P<0.001. The C peptide level was higher at 60 and 120 min alter treatweut as 2.73 (1.05-7.05)ng/ml vs 3.84 (1.22-63.39)ng/ml, P=0.004 and 3.34 (1.42-9.61)ng/ml vs 6.27 (0.93-47.39)ng/ml, P=0.004. The insulin sensitivity was improved as -1.89 ± 0.29 vs -1.70±0.31, P=0.008. With CSII treatment, there were 22.73% patients (5/22) at remission by controlling the diet and excise and 77.27% (17/22) with continuing medication. The patients were followed-up for (12.4 ± 8.5) months, there were 4/5 patients with euglycemia, 1/5 with increase blood sugar and received medication at 2 months after discharge, the rest 17 patients remained oral hypoglycemic medication. <br> Conclusion: CSII may quickly relieve glucotoxicity and improve insulin sensitivity in type 2 diabetes patients with heart diseases. Some patients may alleviate drug burden in clinical practice.
