·糖尿病神经病变·

　　【摘要】 目的 比较不同胰岛素给药方法治疗糖尿病合并脑卒中的疗效。 方法 将76例糖尿病患者分为胰岛素泵持续皮下注射门冬胰岛素(CSII)组及多次皮下注射胰岛素(MSII,4次/d)组。静脉输注5%葡萄糖溶液者，CSII组每4 g葡萄糖同步增加基础量胰岛素1 U;MSII组用微量注射器同步静脉注射胰岛素1 U。 结果 治疗期间血糖平均值、血糖达标时间、低血糖(血糖<2.78 mmol/L)次数两组间比较，差异均有统计学意义[(7.86±1.15) vs (10.05±1.87)mmol/L;(3.53±1.16) vs (6.49±2.75)d;(0.26±0.50) vs (1.03±0.97)次，P<0.01];治疗后14 d，神经功能缺损程度NIHSS评分两组间比较，差异有统计学意义[(21.63±4.73) vs (24.06±5.15)分，P<0.05];并发症发生率、死亡率两组间比较，差异无统计学意义(23.7% vs 39.5%，5.3% vs 10.5%，P>0.05)。发病后3个月,两组Barthel指数评分比较，差异有统计学意义(P<0.05)。 结论 CSII治疗糖尿病合并脑卒中，在血糖控制和神经功能恢复方面疗效优于MSII。

　　【关键词】 糖尿病; 脑卒中; 持续皮下胰岛素注射;多次皮下胰岛素注射;多次皮下胰岛素注射

Therapeutic effect of the continuous subcataneous insulin infusion treatment on the diabetic patients with cerebral apoplexy LI Ming, GAO Zhong-yao. Department of Internal Medicine, Shenwan Hospital, Guangdong 528462, China

Corresponding auther: GAO Zhong-yao,E-mail:731071688@qq.com

　　【Abstract】Objective To compare the effect of different approaches to insulin administration on the diabetic patients with cerebral apoplexy. Methods Seventy-six diabetic patients with cerebral apoplexy were randomly divided into CSII group who were treated by continuous subcutaneous insulin infusion (CSII) of aspart with insulin pump and MSII group who were treated by Multi-subucutaneous insulin injection(MSII). The initial basal rate of 1 U insulin aspart was increased for CSII group and the dosage of 1 U insulin aspart per 4 g glucose was infused by intravenous injection with micro-pump for MSII group for the patients receiving glucose solution by intraveneous drip. Results The the average glycemia, glucose-targeting time, the hypoglycemia events(glycemia<2.78 mmol/L) were significantly different [(7.86±1.15)vs (10.05±1.87)mmol/L;(3.53±1.16)vs(6.49±2.75)d;(0.26±0.50)vs(1.03±0.97)times，P<0.01]. NIHSS score at 14 days during treating was significantly different [(21.63±4.73)vs (24.06±5.15)points，P<0.05]. The complication rate, the death rate was not significantly different(23.7% vs 39.5% ;5.3% vs 10.5%,P>0.05).Conclusion The efficacy of CSII therapy on the decreasing blood glucose and neuro-functional recovery in diabetic patients with cerebral apoplexy is superior to MSII therapy.

　　【Key words】 Diabetes mellitus; Cerebral apoplexy; Continuous subcataneous insulin infusion(CSII); Multiple subcutaneous insulin infusion(MSII)