不同注射方式注射甘精胰岛素血糖控制的临床研究

发布时间：2018-09-08 20:07

【摘要】：目的比较无针注射与胰岛素笔注射甘精胰岛素血糖、胰岛素用量及血糖波动有无差异,为糖尿病治疗提供新的手段。方法选取治疗方案为甘精胰岛素+口服药治疗的糖尿病患者50名,按入院先后随机分配A、B两组,两组分别25名患者,对所有入选患者进行糖尿病教育,使患者规范饮食及生活方式,并停止原治疗方案,予人胰岛素R+N强化治疗3天。3天后A组使用胰岛素笔注射甘精胰岛素,B组使用无针注射器注射甘精胰岛素;两组患者连续监测3天内8段血糖(三餐前30分、餐后120分、晚22时、凌晨3时),并依据血糖调整胰岛素剂量;比较无两组患者空腹血糖变化、胰岛素剂量变化、全天血糖波动。血糖波动通过计算标准差(SD)、平均血糖波动幅度(MAGE)来评价。MAGE计算方法:首先通过动态血糖监测结果计算出患者24小时血糖标准差;然后计算每次血糖波峰与波谷之差为血糖波动幅度(AGE),无论血糖上升或下降支,当大于1个SD时认为是有效的AGE,并以第一个有效AGE方向为准;最后计算它们均数就是MAGE。结果1.无针注射甘精胰岛素与胰岛素笔注射相比较,使用无针注射器组空腹血糖低于使用胰岛素笔组(P0.05);2.无针注射甘精胰岛素与胰岛素笔注射相比较,使用无针注射器组胰岛素剂量少于使用胰岛素笔(P0.05);3.无针注射甘精胰岛素与胰岛素笔注射相比较,两者全天血糖波动无明显差异(P0.05)。结论无针注射方式注射甘精胰岛素与传统注射方式比较,能有效降低空腹血糖且胰岛素剂量减少,无针注射方式注射甘精胰岛素具有良好的临床疗效。
[Abstract]:Objective to compare the difference of insulin glucose, insulin dosage and blood glucose fluctuation between needle free injection and insulin pen injection in order to provide a new method for the treatment of diabetes. Methods A total of 50 patients with diabetes treated with insulin glargine were randomly assigned to two groups according to their admission. 25 patients in the two groups were enrolled in diabetes education. After 3 days of intensive treatment of human insulin, group A used insulin pen to inject insulin glargine and group B used needle free syringe to inject insulin glargine. The patients in the two groups were monitored for 8 levels of blood glucose (30 minutes before three meals, 120 minutes after meal, 22:00 and 3 am) and adjusted insulin dosage according to blood glucose. Blood sugar fluctuates all day. Blood glucose fluctuation was evaluated by calculating standard deviation (SD), mean blood glucose fluctuation amplitude (MAGE). Mage calculation method: first, the 24-hour blood glucose standard deviation of patients was calculated by dynamic blood glucose monitoring results; Then the difference between the peak and trough of each blood glucose wave is calculated as the range of blood glucose fluctuation (AGE), whether the blood sugar rises or falls, the AGE, that is considered valid when more than 1 SD is considered valid and the first effective AGE direction is taken as the criterion; and the final calculation of their mean is MAGE.. Result 1. No needle injection of insulin glargine compared with insulin pen injection, the use of needle-free syringe group fasting blood glucose was lower than the use of insulin pen group (P0.05) 2. No needle injection of insulin glargine compared with insulin pen injection, the use of needle-free syringe group insulin dose is less than the use of insulin pen (P0.05) 3. There was no significant difference in blood glucose fluctuation between insulin injection and insulin pen injection without needle (P0.05). Conclusion compared with traditional injection, injection of insulin without needle injection can effectively reduce fasting blood glucose and decrease the dosage of insulin. Injection of insulin without needle injection has a good clinical effect.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R587.1

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