·糖尿病胰岛素治疗·

　　【摘要】 目的 比较不同给药方法对糖尿病合并与伴发心衰的疗效。 方法 用胰岛素泵持续可变地皮下输注门冬胰岛素(CSII)组，静脉输注5%葡萄糖溶液者，每4克葡萄糖增加基础量胰岛素1 U。4次/d 皮下注射胰岛素(MSII)组。 结果 两组治疗24 h时平均血糖值、疗效、治疗后B型尿钠肽(BNP)及LVEF、低血糖事件发生率比较差异有统计学差异(P ≤ 0.01)。 结论 CSII治疗糖尿病并/伴心衰疗效优于MSII。

　　【关键词】 糖尿病;充血性心力衰竭;门冬胰岛素;胰岛素泵

Effect of the CSII treatment on the diabetic patients with congestive heart failure LI Ming, GAO Zhong-yao, HUANG Jia-yu. Department of Internal Medicine, Shenwan Hospital, Zhongshan 528462, China

　　【Abstract】 Objective To compare the effect of different approaches of insulin administration on the diabetic patients with congestive heart failure (CHF). Methods  The continuous subcutaneous insulin infusion (CSII) group was treated with insulin aspart infusion with insulin pump, for those who had intravenous infusion of 5% glucose, the initial basal rate of insulin aspart was 1U increased per 4g glucose.   The MSII group was treated with multi-subcutaneous insulin injection 4 times per day. Results The averaged BG at 24 hour after receiving treatment, the efficacy, the B-type natriuretic protein (BNP), the left ventricular ejection fraction (LVEF), and the incidence of hypoglycemia were significantly different between the two groups (P≤0.01). Conclusion The efficacy of the CSII therapy for the diabetic patients with CHF is superior to that of the MSII therapy.

　　【Key words】 Diabetes mellitus;Congestive heart failure;Insulin aspart;CSII therapy; Insulin pump