目的：分析强化血糖控制对急性胰腺炎（AP）患者血糖波动及新发糖尿病的影响。方法 AP患者72例分为两组，观察组（n=36）采用微量泵持续泵入胰岛素，将血糖控制在4.4~6.1mmol/L，对照组（n=36）采用常规胰岛素治疗，将血糖控制在<10.1mmol/L。观察两组治疗前后血糖及预后相关指标的变化，记录两组患者的血糖变异性（GV）、低血糖发生率、28d病死率及后期糖尿病发病情况，采用多因素Logistic回归分析GV与新发糖尿病的相关性。结果治疗后3、7d，观察组FBG、APACHEⅡ评分较治疗前显著下降，且显著低于对照组（P<0.05）；与对照组比较，观察组患者的胰岛素使用时间、抗生素使用时间、住院时间均明显缩短，血糖变异性（GV）、新发糖尿病的发生率显著降低（P<0.05）；两组低血糖发生率、28d病死率比较，差异均无统计学意义（P>0.05）；Logistic回归分析显示，GV是AP患者后期新发糖尿病的独立危险因素（OR=3.17，P<0.05）。结论强化血糖控制可有效降低血糖波动，促进胰腺功能恢复，减少后期发生糖尿病的风险，改善预后。%ObjectiveTo explore the impact of intensive glycemic control for glucose variability and new-onset diabetes on patients with acute pancreatitis(AP).Methods72 cases of AP patients were divided into two groups,observation group(n=36)underwentn insulin therapy intensified into a continuous pump to control blood glucose at 4.4~6.1mol/L,control group was treated with conventional insulin treatment to control blood glucose below 10.1 mol/L. Change of blood glucose related indicators before and after treatment and prognosis between two groups were observed,the GV,incidence of hypoglycemia and 28 days mortality were recorded,and Logistic regression was performed for the correlation between GV and new-onset diabetes. Result:FBG and APACHEⅡscore in treatment group were significantly lower than those before treatment and in control group at 3rd and 7th day after treatment (P<0.05). There were significant difference’in the hospitalization time,consumption of antibiotics and insulin between two groups,GV and incidence of new-onset diabetes were significantly lower than those in control group(P<0.05),while there were no significant difference on incidence of hypoglycemia and 28 days mortality between two groups(P>0.05). Logistic regression analysis showed that GV was the independent risk factors of new-onset diabetes in patients with AP(OR=3.17,P<0.05).ConclusionIntensive glycemic control can effectively reduce the blood sugar fluctuation for AP patients,promote the pancreas function recovery,reduce the risk of diabetes,and improve the prognosis.
展开▼
