中华糖尿病杂志
中華糖尿病雜誌
중화당뇨병잡지
CHINES JOURNAL OF DLABETES MELLITUS
2013年
5期
279-281
,共3页
王宇%闫娜娜%卫国红%李海%李延兵%廖志红
王宇%閆娜娜%衛國紅%李海%李延兵%廖誌紅
왕우%염나나%위국홍%리해%리연병%료지홍
糖尿病,1型%胰岛素过敏%胰岛素输注系统
糖尿病,1型%胰島素過敏%胰島素輸註繫統
당뇨병,1형%이도소과민%이도소수주계통
Diabetes mellitus,type 1%Insulin allergy%Insulin infusion systems
目的 报告对多种胰岛素过敏的1型糖尿病患者脱敏随访治疗情况,并复习国内外报道的相关资料,以提高对该病的诊治认识.方法 对该患者用过小剂量序贯皮下注射胰岛素、胰岛素泵持续泵入胰岛素(诺和灵R、猪胰岛素)、地塞米松加入胰岛素泵诺和灵R中持续泵入等方法进行胰岛素脱敏治疗.监测指标为患者胰岛素注射部位的红斑、硬结直径及瘙痒程度以及胰岛素抗体水平.结果 胰岛素泵治疗时,过敏反应较前明显减轻,尤其是方波输注模式时瘙痒明显减少.使用诺和灵R+地塞米松胰岛素泵治疗时最少发生过敏反应,表现为注射部位无红斑,无硬结或偶有直径0.5 cm的硬结,不伴瘙痒；胰岛素泵治疗结束3个月,胰岛素笔注射后,皮肤过敏反应逐渐减轻至消失,无红斑和瘙痒,大腿部位有时有小硬结,胰岛素抗体逐渐降低至正常,但出现右侧腹部局部脂肪萎缩.结论 地塞米松与胰岛素混合加入胰岛素泵的方法胰岛素过敏反应最轻微,胰岛素泵方波输注模式有助减轻胰岛素过敏症状.
目的 報告對多種胰島素過敏的1型糖尿病患者脫敏隨訪治療情況,併複習國內外報道的相關資料,以提高對該病的診治認識.方法 對該患者用過小劑量序貫皮下註射胰島素、胰島素泵持續泵入胰島素(諾和靈R、豬胰島素)、地塞米鬆加入胰島素泵諾和靈R中持續泵入等方法進行胰島素脫敏治療.鑑測指標為患者胰島素註射部位的紅斑、硬結直徑及瘙癢程度以及胰島素抗體水平.結果 胰島素泵治療時,過敏反應較前明顯減輕,尤其是方波輸註模式時瘙癢明顯減少.使用諾和靈R+地塞米鬆胰島素泵治療時最少髮生過敏反應,錶現為註射部位無紅斑,無硬結或偶有直徑0.5 cm的硬結,不伴瘙癢；胰島素泵治療結束3箇月,胰島素筆註射後,皮膚過敏反應逐漸減輕至消失,無紅斑和瘙癢,大腿部位有時有小硬結,胰島素抗體逐漸降低至正常,但齣現右側腹部跼部脂肪萎縮.結論 地塞米鬆與胰島素混閤加入胰島素泵的方法胰島素過敏反應最輕微,胰島素泵方波輸註模式有助減輕胰島素過敏癥狀.
목적 보고대다충이도소과민적1형당뇨병환자탈민수방치료정황,병복습국내외보도적상관자료,이제고대해병적진치인식.방법 대해환자용과소제량서관피하주사이도소、이도소빙지속빙입이도소(낙화령R、저이도소)、지새미송가입이도소빙낙화령R중지속빙입등방법진행이도소탈민치료.감측지표위환자이도소주사부위적홍반、경결직경급소양정도이급이도소항체수평.결과 이도소빙치료시,과민반응교전명현감경,우기시방파수주모식시소양명현감소.사용낙화령R+지새미송이도소빙치료시최소발생과민반응,표현위주사부위무홍반,무경결혹우유직경0.5 cm적경결,불반소양；이도소빙치료결속3개월,이도소필주사후,피부과민반응축점감경지소실,무홍반화소양,대퇴부위유시유소경결,이도소항체축점강저지정상,단출현우측복부국부지방위축.결론 지새미송여이도소혼합가입이도소빙적방법이도소과민반응최경미,이도소빙방파수주모식유조감경이도소과민증상.
Objective To investigate the anti-allergic strategy by reporting the desensitization for one case of insulin allergic type 1 diabetes and reviewing relevant literatures.Methods Sequencing diluted insulin injection for desensitization,continuous subcutaneous insulin infusion (CSⅡ) with Novolin R,or dexamethasone added into CSⅡ were applied to desensitization.Observed the size of erythema and induration,the degree of itching around the site of insulin injection and measured the insulin antibody levels.Results The allergic reaction obviously alleviated during CSⅡ,especially when the square mode of bolus was used.The slightest allergic reaction was seen during CSⅡ with Dexamethasone,showing a small induration without erythema or itching.Three months after CSⅡ,the erythema or itching around injection sites disappeared,except occasional small indurations at the thighs.The insulin antibody levels gradually declined to normal as well.However,a local lipoatrophy in the right abdomen turned up.Conclusions The allergic reaction is alleviated most when dexamethasone and insulin added into CSⅡ.The square mode of bolus is helpful to alleviate the insulin allergic symptoms.
