CAJ | 학술논문

目的：分析预混胰岛素对糖尿病合并肺部感染患者血糖控制及感染结局的影响。方法选取2011年12月至2012年12月南京军区南京总医院收治的肺部感染糖尿病患者共146例。采用随机数字表法将患者分为预混胰岛素甘舒30R 组（72例）和二甲双胍组（74例）。其中预混胰岛素甘舒30R 组患者采用预混胰岛素治疗，患者在餐前30 min 进行皮下注射0.2～0.4 U／kg，连续治疗3个月；二甲双胍组患者采用常规口服二甲双胍500 mg／d，连续治疗3个月，比较两组患者血糖控制情况及感染结局。结果两组患者治疗前空腹血糖、餐后2 h 血糖及糖化血红蛋白比较差异无统计学意义（P ＞0.05）；治疗3个月后，预混胰岛素甘舒30R 组患者的空腹血糖、餐后2 h 血糖及糖化血红蛋白水平均显著低于二甲双胍组［（5.2±0.7） mmol／L 比（8.5±1.8） mmol／L、（7.6±0.3） mmol／ L 比（12.0±2.0） mmol／L、（5.66±1.24）％比（12.0±2.0）％，均P ＜0.01］，且两组空腹血糖、餐后2 h 血糖及糖化血红蛋白水平均较治疗前显著下降（P ＜0.05）；二甲双胍组患者高血糖的发生率显著高于预混胰岛素甘舒30R 组［56.8％（42／72）比20.8％（15／74），P ＜0.05］，而低血糖的发生率与预混胰岛素甘舒30R 组比较差异无统计学意义［44.4％（32／72）比37.5％（27／74），P ＞0.05］；两组患者治疗3个月后，预混胰岛素甘舒30R 组患者临床总有效率明显高于二甲双胍组，差异有统计学意义（P ＜0.05）。结论预混胰岛素治疗糖尿病合并肺部感染患者能有效降低并且控制患者的血糖水平，提高肺部感染治疗的效果。
목적：분석예혼이도소대당뇨병합병폐부감염환자혈당공제급감염결국적영향。방법선취2011년12월지2012년12월남경군구남경총의원수치적폐부감염당뇨병환자공146례。채용수궤수자표법장환자분위예혼이도소감서30R 조（72례）화이갑쌍고조（74례）。기중예혼이도소감서30R 조환자채용예혼이도소치료，환자재찬전30 min 진행피하주사0.2～0.4 U／kg，련속치료3개월；이갑쌍고조환자채용상규구복이갑쌍고500 mg／d，련속치료3개월，비교량조환자혈당공제정황급감염결국。결과량조환자치료전공복혈당、찬후2 h 혈당급당화혈홍단백비교차이무통계학의의（P ＞0.05）；치료3개월후，예혼이도소감서30R 조환자적공복혈당、찬후2 h 혈당급당화혈홍단백수평균현저저우이갑쌍고조［（5.2±0.7） mmol／L 비（8.5±1.8） mmol／L、（7.6±0.3） mmol／ L 비（12.0±2.0） mmol／L、（5.66±1.24）％비（12.0±2.0）％，균P ＜0.01］，차량조공복혈당、찬후2 h 혈당급당화혈홍단백수평균교치료전현저하강（P ＜0.05）；이갑쌍고조환자고혈당적발생솔현저고우예혼이도소감서30R 조［56.8％（42／72）비20.8％（15／74），P ＜0.05］，이저혈당적발생솔여예혼이도소감서30R 조비교차이무통계학의의［44.4％（32／72）비37.5％（27／74），P ＞0.05］；량조환자치료3개월후，예혼이도소감서30R 조환자림상총유효솔명현고우이갑쌍고조，차이유통계학의의（P ＜0.05）。결론예혼이도소치료당뇨병합병폐부감염환자능유효강저병차공제환자적혈당수평，제고폐부감염치료적효과。
Objective To analyze the effect of premixed insulin on glycemic control and infection out-come in diabetic patients with pulmonary infection .Methods A total of 146 diabetic patients with lung infections in Nanjing General Hospital from Dec.2011 to Dec.2012 were chosen.According to random num-ber table method,the patients were divided into Gan Shu 30R premixed insulin group(72 cases) and met-formin group(74 cases) group.Gan Shu 30R premixed insulin group was treated with pre-mixed insulin ther-apy,the patients received subcutaneous injection of 0.2-0.4 U/kg 30 min before meal,continuously for three months; metformin group was treated with conventional oral hypoglycemic agents 500 mg/d,continuously for three months,and the glycemic control and infection outcome of the two groups were compared .Results The fasting plasma glucose,2 h postprandial blood glucose and glycated hemoglobin in the two groups had no sta-tistically significant difference(P >0.05);after 3 months treatment,the fasting glucose,2 h postprandial blood glucose and glycated hemoglobin in Gan Shu 30 R premixed insulin group were significantly lower than the metformin group[(5.2 ±0.7) mmol/L vs (8.5 ±1.8) mmol/L,(7.6 ±0.3) mmol/L vs (12.0 ± 2.0) mmol/L,(5.66 ±1.24)% vs (12.0 ±2.0)%,P <0.05],and the two sets significantly decreased than before treatment(P<0.01);the incidence of hyperglycemia in patients of metformin group was signifi-cantly higher than the Shu Gan 30R mixed insulin group[56.8% (42/72) vs 20.8% (15/74),P <0.05],and the incidence of hypoglycemia had no statistically significant difference [44.4% (32/72) vs 37.5% (27/74),P>0.05];after 3 months of treatment,the total effective rate of premixed insulin30 R Shu Gan group was statistically significantly higher than metformin group ( P <0.05 ) .Conclusion Premixed insulin can effectively reduce blood sugar levels in diabetes patients with pulmonary infection,and improve the treatment effect of pulmonary infection .