赖脯胰岛素联合平衡盐溶液治疗急诊成人糖尿病酮症酸中毒患者的临床观察OA
Clinical observation of insulin lispro combined with balanced salt solution in the treatment of adult emergency patients with diabetic ketoacidosis
目的 探究赖脯胰岛素联合平衡盐溶液治疗急诊成人糖尿病酮症酸中毒(DKA)患者的临床效果.方法 将DKA患者根据治疗方法分为对照组与试验组.2组同时予以静脉输注平衡盐溶液补液,对照组予以门冬胰岛素,试验组予以赖脯胰岛素.比较2组的血糖控制效果、酸中毒改善情况、安全性.结果 对照组入组44例,试验组入组48例.治疗后,对照组的空腹血糖(FBG)为(5.77±1.08)mmol·L-1,餐后2 小时血糖(2-hour postprandial glucose,2 h PG)为(12.11±4.27)mmol·L-1,平均血糖波动幅度(MAGE)为(3.48±1.04)mmol·L-1,24 h 平均血糖水平(24 h MBG)为(7.84±1.57)mmol·L-1,β-羟丁酸(beta-hydroxybutyrate,β-HB)为(0.35±0.11)mmol·L-1,二氧化碳结合力(CO2CP)为(20.06±6.43)mmol·L-1,酸碱度(pH)值为 7.58±1.13;试验组的FBG 为(5.36±1.26)mmol·L-1,2 h PG 为(10.22±2.52)mmol·L-1,MAGE为(3.32±0.92)mmol·L-1,24 h MBG为(7.60±1.44)mmol·L-1,β-HB 为(0.30±0.14)mmol·L-1,CO2 CP 为(21.34±6.54)mmol·L-1,pH 为7.55±1.07,试验组的FBG、2 h PG、MAGE、24 h MBG水平低于对照组,在统计学上差异均有统计学意义(均P＜0.05),2组β-HB、CO2 CP、酸碱度(pH)值比较,在统计学上差异均无统计学意义(均P＞0.05).对照组发生1例低血糖,试验组发生3例低血糖,2组均未发生腹胀等胃肠道不良反应,2组不良反应总发生率在统计学上无显著性差异(P＞0.05).结论 赖脯胰岛素联合平衡盐溶液治疗急诊成人DKA患者可有效控制患者血糖、改善酸中毒及电解质水平,对肾功能未见明显不良影响,且安全性好.
Objective To explore the clinical effect of insulin lispro combined with balanced salt solution in the treatment of adult emergency patients with diabetic ketoacidosis(DKA).Methods DKA patients were divided into a control group and an experimental group according to the treatment method.Both groups were given intravenous infusion of balanced salt solution for rehydration at the same time.The control group was given insulin aspart,and the experimental group was given insulin lispro.The blood glucose control efficacy,improvement of acidosis,and safety were compared between the two groups.Results There were 44 patients enrolled in the control group and 48 patients in the experimental group.After treatment,the fasting blood glucose(FBG)of the control group was(5.77±1.08)mmol·L-1,the 2-hour postprandial glucose(2 h PG)was(12.11±4.27)mmol·L-1,the mean amplitude of glycemic excursions(MAGE)was(3.48±1.04)mmol·L-1,the 24-hour mean blood glucose(24 h MBG)was(7.84±1.57)mmol·L-1,the beta-hydroxybutyrate(β-HB)was(0.35±0.11)mmol·L-1,the carbon dioxide combining power(CO2 CP)was(20.06±6.43)mmol·L-1,and the potential of hydrogen(pH)value was 7.58±1.13.For the experimental group,the FBG was(5.36±1.26)mmol·L-1,the 2 h PG was(10.22±2.52)mmol·L-1,the MAGE was(3.32±0.92)mmol·L-1,the 24 h MBG was(7.60±1.44)mmol·L-1,the β-HB was(0.30±0.14)mmol·L-1,the CO2CP was(21.34±6.54)mmol·L-1,and the pH was 7.55±1.07.The experimental group had significantly lower levels of FBG,2 h PG,MAGE,and 24 h MBG compared to the control group(all P＜0.05).There was no significant difference in β-HB,CO2CP,and pH value between the two groups(all P＞0.05).There was 1 case of hypoglycemia in the control group and 3 cases of hypoglycemia in the experimental group.There were no gastrointestinal adverse reactions such as abdominal distension in both groups,and there was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05).Conclusion Insulin lispro combined with balanced salt solution can effectively control blood glucose,improve acidosis and electrolyte levels,exert no significant adverse effects on renal function,and has good safety in the treatment of adult emergency DKA patients.
程超;郁慧杰
嘉兴市第一医院/嘉兴大学附属医院急诊科,浙江嘉兴 314001嘉兴市第一医院/嘉兴大学附属医院急诊科,浙江嘉兴 314001
医药卫生
赖脯胰岛素平衡盐溶液糖尿病酮症酸中毒酸中毒急诊血糖控制
insulin lisprobalanced salt solutiondiabetic ketoacidosisacidosisemergency treatmentglycemic control
《中国临床药理学杂志》 2026 (6)
770-775,6
嘉兴市急诊医学重点支撑学科建设项目(2023-ZC-004)
评论