动态血糖监测联合胰岛素泵治疗对糖尿病患者生活质量的影响

摘要

目的：探讨动态血糖监测系统（ CGMS）联合胰岛素泵持续皮下胰岛素输注（ CSII）治疗对2型糖尿病患者生活质量的影响。方法选取2011年2月至2013年2月北京军区总医院收治的新诊断2型糖尿病患者126例，依据随机数字表法分为3组，各42例。 A组给予CGMS联合CSII治疗， B组给予指血血糖监测联合CSII治疗，C组给予指血血糖监测联合胰岛素多次皮下注射治疗。比较3组患者的各血糖参数，采用 SF－36简式健康状况调查表（ SF－36）及修订版糖尿病生活质量量表（A－DQOL）评价患者的生活质量。结果强化治疗后A、B、C组患者的空腹血糖[（6．8±1．1） mmol／L、（7．3±1．4） mmol／L、（7．1±1．7） mmol／L]，餐后2 h血糖[（8．4±1．0） mmol／L、（9．4±1．3） mmol／L、（9．5±2．3） mmol／L]均较治疗前[（10．9±1．8） mmol／L、（10．6±2．3） mmol／L、（11．0±1．8） mmol／L；（15．0±2．8） mmol／L、（14．9±2．5） mmol／L、（15．3±2．4） mmol／L]明显下降（P＜0．01）；而平均血糖漂移度（MAGE）水平只有A组在治疗后较治疗前下降[（3．3±1．1） mmol／L比（5．3±1．5） mmol／L]（P＜0．05）；随访结果表明，各组低血糖事件的发生次数、糖化血红蛋白和 MAGE水平及 SF－36量表各维度的评分值差异均有统计学意义（ P＜0．01）；A－DQOL量表项目满意度，糖尿病相关忧虑维度和总体生活质量评分值差异均有统计学意义（P＜0．05）。结论 CGMS联合胰岛素泵强化治疗能更好地改善2型糖尿病患者的总体生活质量。%Objective To investigate the effects of continuous glucose monitoring system ( CGMS) com-bined with continuous subcutaneous insulin injection(CSII) on life quality in patients with type 2 diabetes mellitus.Methods A total of 126 patients with newly diagnosed type 2 diabetes mellitus hospitalized in Gen-eral Hospital of Beijing Military Region from Feb.2011 to Feb.2013 were selected,and randomly divided into three groups,42 cases in each group.Group A was treated with CGMS combined with CSII therapy,group B was given finger-tip blood glucose monitoring with CSII,group C was given finger-tip blood glucose monitoring with multiple daily subcutaneous injection .The blood parameters of the three groups were compared .The Medical Outcomes-36 Item Short Form Health Survey ( SF-36 ) and Adjusted Diabetes Quality of Life (A-DQOL) were used to survey the life quality of the patients.Results After intensive treatment,fasting plasma glucose [ ( 6.8 ±1.1 ) mmol/L, ( 7.3 ±1.4 ) mmol/L, ( 7.1 ±1.7 ) mmol/L ] and 2 h plasma glucose [(8.4 ±1.0) mmol/L,(9.4 ±1.3) mmol/L,(9.5 ±2.3) mmol/L] levels of the group A,B,C, decreased significantly than before treatment[(10.9 ±1.8) mmol/L,(10.6 ±2.3) mmol/L,(11.0 ±1.8) mmol/L;(15.0 ±2.8) mmol/L,(14.9 ±2.5) mmol/L,(15.3 ±2.4) mmol/L] (P<0.01).The mean amplitude of glycemic excursions ( MAGE) level of group A was lower after treatment than before treatment [(3.3 ±1.1) mmol/L vs (5.3 ±1.5) mmol/L ](P<0.05);The followed-up results showed that hypogly-cemia,HbA1c ,MAGE level and SF-36 scale scores in every dimensions of all the groups were significantly different(P<0.01).The A-DQOL scale satisfaction,diabetes related anxiety dimensions and overall quality of life scores were significantly different(P<0.05).Conclusion CGMS combined with CSII can effectively improve the overall life quality of patients with type 2 diabetes mellitus.