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目的:比较普通胰岛素与速效胰岛素类似物(诺和锐)治疗糖尿病酮症酸中毒(diabetic ketoacidosis,DKA)的疗效和安全性。方法:将37例住院DKA患者分为普通胰岛素治疗组(RI组)20例和胰岛素类似物治疗组(NR组)17例,对比2组间血糖、血糖达标时间、血糖达标时胰岛素用量、尿酮变化、血液酸碱度及治疗过程中低血糖的发生次数,探讨DKA治疗方案。结果:2组患者的血糖治疗后均明显下降,NR组治疗DKA所用胰岛素总量显著低于RI组(P<0.01);尿酮转阴时间及纠正酸中毒所需时间,NR组与RI组差异无显著性;NR组低血糖发生次数显著少于RI组(P<0.01)。结论:糖尿病酮症酸中毒治疗过程中,在无差异的血糖达标时间内,静脉泵注入速效胰岛素类似物较普通胰岛素降糖时所用胰岛素量更小,低血糖发生次数更少,具有更优的疗效和安全性。
Objective: To compare the efficacy and safety of common insulin and rapid-acting insulin analogue (Novo-sharp) in the treatment of diabetic ketoacidosis (DKA). Methods: Twenty-seven inpatients with DKA were divided into two groups: normal insulin group (RI group) and insulin analog group (NR group), 17 patients. The blood glucose, blood glucose level, insulin dosage, Changes, blood pH and the incidence of hypoglycemia in the course of treatment to explore the DKA treatment. Results: The blood glucose of the two groups were significantly decreased after treatment, the total amount of insulin used in the treatment of DKA NR group was significantly lower than the RI group (P <0.01); urinary ketone conversion time and correct the time required for acidosis, NR group and RI group There was no significant difference in the incidence of hypoglycemia between NR group and RI group (P <0.01). CONCLUSION: During the treatment of diabetic ketoacidosis, intravenous infusion of fast-acting insulin analogs has less insulin and less hypoglycemia than normal insulin in the duration of undifferentiated glycemic control and has better Efficacy and safety.