动态血糖监测2型糖尿病胰岛素强化治疗中的低血糖反应(1)
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[摘要] 目的：研究动态血糖监测2型糖尿病胰岛素强化治疗中低血糖反应的准确性。方法：选取2007年1～12月在我院住院的50例2型胰岛素强化治疗糖尿病患者作为研究对象，随机分为两组，常规组采用指端监测护理，CGMS组采用动态血糖监测系统(CGMS)监测护理，比较两种血糖监测方法的检出率。结果：常规组与CGMS组患者胰岛素强化治疗中低血糖反应的发生例次间比较，差异无统计学意义，但CGMS组监测到的例次和检出率与常规组间比较，有显著性差异(χ2=11.50，P<0.05)。尤其是对于无症状低血糖的监测检出率，两组间比较，有非常显著性差异(χ2=21.47，P<0.01)。结论：2型糖尿病胰岛素强化治疗过程中，CGMS监测低血糖反应的检出率高于常规监测方法。
[关键词] 2型糖尿病；动态血糖监测系统；胰岛素；低血糖反应；强化治疗
[中图分类号] R473.5[文献标识码]A [文章编号]1673-7210(2009)01(a)-039-02
The continuous glucose monitoring of hypoglycaemia reaction to type 2 diabetes mellitus patients treated with insulin intensification therapy
LIU Chun-li1, XIAO Xue2
(The Sixth People's Hospital of Shenzhen City, Shenzhen518052, China)
[Abstract] Objective: To study the continuous glucose monitoring of hypoglycaemia reaction to type 2 diabetes mellitus patients treated with insulin intensification therapy. Methods: Fifty patients undergoing insulin intensification therapy were divided into two groups during 2007. Glucose of patients in routine group were monitored with finger tip monitoring method,while those in CGMS group were monitored with continuous glucose monitoring system(CGMS). Detection rate was judge standards. Results: The patients in two groups had the same frequency of hypoglycaemia reaction. While the differences of detection rate had statistical significance between the two groups (χ2=11.50,P<0.05), especially the detection rate to symptomless hypoglycaemia reaction had highly significant difference (χ2=21.47,P<0.01). Conclusion: CGMS has higher detection rate than routine methods to hypoglycaemia reaction to type 2 diabetes mellitus patients treated with insulin intensification therapy.
[Key words] Type 2 diabetes mellitus; Continuous glucose monitoring system (CGMS); Insulin; Hypoglycaemia reaction; Intensification therapy
随着2型糖尿病发生率的逐年增加，有效控制血糖浓度已引起广泛重视，胰岛素强化治疗糖尿病虽能够在短时间内控制血糖，但低血糖反应随之而来。在糖尿病控制与并发症研究中发现，强化治疗的患者严重低血糖(需要治疗的低血糖)的发生率比接受常规治疗者增加了3倍。若能及时发现、治疗，低血糖多能很快得到纠正，而糖尿病低血糖死亡率高的原因主要是发现、治疗不及时所致。动态血糖监测系统(CGMS)能24 h连续监测患者血糖的变化，为密切观察强化治疗期间患者血糖的细微变化提供了可能[1,2]。我院应用CGMS对2型糖尿病患者胰岛素强化治疗的血糖情况进行监测护理，均能及时准确地发现低血糖反应，对临床治疗和护理方案的制定具有重要意义 ......
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