刘林华 姚瑾 陈彦

[摘要] 目的 评价胰岛素泵、皮下注射治疗老年2型糖尿病合并肺部感染的疗效。方法 选取2015年5月—2017年11月医院呼吸内科、感染科、内分泌收治的老年2型糖尿病合并肺部感染患者80例，按照病历号分组。对照组40例，一次性注射器皮下注射用药，观察组40例，胰岛素泵用药，对比血糖控制情况、疗效。结果 观察组与对照组入院时血糖、初次血糖达标时间比较差异无统计学意义（P>0.05），观察组24 h平均血糖、48 h平均血糖、血糖不稳定指数、72 h内低血糖发生次数低于对照组，差异有统计学意义（P<0.05）。观察组感染控制时间（5.6±1.4）d、住院时间（11.3±3.5）d低于对照组，差异有统计学意义（P<0.05）。结论 胰岛素泵用药辅助治疗老年2型糖尿病合并肺部感染疗效肯定，有助于降低血糖变异性，提高血糖控制效果。

[关键词] 老年人；2型糖尿病；肺部感染；胰岛素

[中图分类号] R58 [文献标识码] A [文章编号] 1672-4062（2018）02（b）-0007-02

Clinical Analysis of Insulin Therapy in Elderly Type 2 Diabetes Patients with Pulmonary Infection

LIU Lin-hua， YAO Jin， CHEN Yan

Department of Internal Medicine， Fujian Provincial Hospital， Fuzhou， Fujian Province， 350000 China

[Abstract] Objective This paper tries to evaluate the efficacy of insulin pump and subcutaneous injection in the treatment of type 2 diabetes mellitus with pulmonary infection in the elderly. Methods From May 2015 to November 2017， 80 elderly patients with type 2 diabetes mellitus complicated with pulmonary infection who were admitted to the Department of Respiratory Medicine， Infectious Diseases， and Endocrinology were grouped according to the medical record number. In the control group， 40 patients were treated with subcutaneous injections using disposable syringes， 40 patients in the observation group adopted insulin pumps， the control of blood glucose and efficacy were compared. Results There was no statistically significant difference between the observation group and the control group（P>0.05）. The 24-hour mean blood glucose， 48-hour average blood glucose， blood sugar instability index， and the number of hypoglycemia within 72 hours were lower in the observation group than in the control group. And the difference was statistically significant（P<0.05）. The infection control time（5.6±1.4） days and hospitalization timeays（11.3±3.5）d in the observation group were lower than those in the control group， and the difference was statistically significant（P<0.05）. Conclusion The use of insulin pump to treat elderly patients with type 2 diabetes mellitus with pulmonary infection is effective， which helps to reduce blood glucose variability and improve blood glucose control.

[Key words] Elderly； Type 2 diabetes； Pulmonary infections； Insulin

2型糖尿病是老年人常見的基础疾病，发生率高达20%。2型糖尿病与感染关系密切，这可能与2型糖尿病引起的免疫功能受损、血糖波动所致细胞损伤、脏器功能减退等因素有关[1]。肺炎的发生反过来又会影响血糖，增加血糖变异性，重症感染会引起血糖生产、代谢失衡，诱发高血糖，加重病情，形成恶性循环[2]。胰岛素是治疗老年2型糖尿病的主要方法，疗效肯定，但目前尚无规范化的治疗方法，有关于胰岛素使用方法、药物品种的选择有待商榷。该次研究于2015年5月—2017年11月采用对比分析，评价胰岛素泵、皮下注射治疗老年2型糖尿病合并肺部感染的疗效。

1 资料与方法

1.1 一般资料

以医院呼吸内科、感染科、内分泌科收治的老年2型糖尿病合并肺部感染患者入组。纳入标准：①出现咳嗽、咳痰、发热、肺部湿罗音或肺实变体征等临床表现，实验室、X线检查确诊为肺炎；②……