CAJ | 학술논문

目的研究胰岛素泵用门冬胰岛素联合口服药物治疗老年髋部骨折急性期伴高血糖时的剂量及安全性. 方法 1周内发生髋部骨折伴高血糖需要使用胰岛素泵治疗患者依年龄分为老年组(≥65岁,42例)和为非老年组(＜65岁,43例),所有患者均进行严格饮食管理,胰岛素泵给予门冬胰岛素联合口服药物控制血糖,比较达标时门冬胰岛素用量及使用过程中患者出现的不良事件.结果老年组、非老年组达标时每公斤体质量基础门冬胰岛素用量分别为(0.29±0.09) IU/kg和(0.30±0.07) IU/kg,餐前追加量分别为(0.27±0.09) IU/kg和(0.27±0.07) IU/kg;无症状低血糖分别为14.3％和18.6％;有症状低血糖分别为4.8％和4.7％;伴有意识障碍的低血糖、过敏反应、出现伤口不愈或延迟愈合者二组均未发生;联合应用的口服药物包括二甲双胍、格列美脲及糖苷酶的抑制剂,使用比率在两组间均无差别. 结论严格的饮食控制联合口服药物,门冬胰岛素经胰岛素泵可控制老年髋部骨折急性期患者高血糖,安全性良好.
목적 연구이도소빙용문동이도소연합구복약물치료노년관부골절급성기반고혈당시적제량급안전성. 방법 1주내발생관부골절반고혈당수요사용이도소빙치료환자의년령분위노년조(≥65세,42례)화위비노년조(＜65세,43례),소유환자균진행엄격음식관리,이도소빙급여문동이도소연합구복약물공제혈당,비교체표시문동이도소용량급사용과정중환자출현적불량사건.결과 노년조、비노년조체표시매공근체질량기출문동이도소용량분별위(0.29±0.09) IU/kg화(0.30±0.07) IU/kg,찬전추가량분별위(0.27±0.09) IU/kg화(0.27±0.07) IU/kg;무증상저혈당분별위14.3％화18.6％;유증상저혈당분별위4.8％화4.7％;반유의식장애적저혈당、과민반응、출현상구불유혹연지유합자이조균미발생;연합응용적구복약물포괄이갑쌍고、격렬미뇨급당감매적억제제,사용비솔재량조간균무차별. 결론 엄격적음식공제연합구복약물,문동이도소경이도소빙가공제노년관부골절급성기환자고혈당,안전성량호.
Objective To investigate the dosage and safety of insulin aspart in continuous subcutaneous insulin infusion plus oral antidiabetic drugs for the treatment of hyperglycemia in elderly hip fracture.Methods Patients with hip fracture and hyperglycemia who required insulin pump therapy were divided into 2 groups according to age:elderly group (patients aged over 65 years,n=42) and non-elderly group (patients aged under 65 years,n=43).All patients were treated with insulin aspart in continuous subcutaneous insulin infusion plus oral antidiabetic drugs combined with diet therapy.Dosages of aspart insulin and adverse effects were compared between the two groups.Results There were no significant differences in basic aspart dosage and additional premeal dosage between elderly and non-elderly groups [(0.29±0.09) IU/kg vs.(0.30±0.07) IU /kg,(0.27±0.09) IU/kg vs.(0.27±0.07) IU/kg,both P＞0.05].The incidences of hypoglycemia with and without symptoms in elderly versus non-elderly groups were 4.8％ vs.4.7％ and 14.3％ vs.18.6％,which had no significant differences between the two groups (P＞0.05).Hypoglycemia accompanied by consciousness disorders,allergy,nonhealing and slow healing wounds were not found in the two groups.The ratio of oral antidiabetic drugs including metformin,glimepiride,and glycosidase inhibitor had no differences between the two groups.Conclusions Aspart insulin in continuous subcutaneous insulin infusion is effective and safe in the treatment of acute severe hyperglycemia in elderly patients with hip fractures when combined with diet therapy and oral antidiabetic drugs.