临床误诊误治2023，Vol.36Issue(8)：46-51,6.DOI:10.3969/j.issn.1002-3429.2023.08.010
微量泵持续胰岛素泵入联合奥曲肽治疗糖尿病酮症酸中毒的作用机制研究
Mechanism of Continuous Pumping of Insulin with Micropump Combined with Octreotide in the Treatment of Diabetic Ketoacidosis
摘要
Abstract
Objective To investigate the mechanism of action of continuous pumping of insulin with micropump com-bined with Octreotide in the treatment of diabetic ketoacidosis(DKA)based on the IRS-1/PI3K/GLUT4 insulin metabolic pathway.Methods Sixty patients with DKA treated from October 2019 to October 2021 were selected as the research sub-jects and divided into control group(n =30)and observation group(n =30)according to different administration methods.The control group was treated with slow intravenous insulin infusion combined with Octreotide,and the observation group was treated with continuous pumping of insulin with micropump combined with Octreotide.The clinical efficacy,symptom improve-ment time,length of hospital stay,maintenance dosage of insulin,blood glucose control level,blood gas analysis,oxidative stress response,expression of IRS-1/PI3K/GLUT4 insulin metabolic pathway and incidence of hypoglycemia were compared between the two groups.Results The total effective rate of the observation group was 93.33%(28/30),which was higher than that of the control group[70.00%(21/30)](P＜0.05).The time of positive-to-negative conversion of urine ketone body,the time of blood glucose reaching the standard and the length of hospitalization in the observation group were shorter than those in the control group,and the maintenance dosage of insulin was lower than that in the control group(P＜0.05).At 3 and 7 days after treatment,fasting blood glucose,2 h postprandial blood glucose,glycated hemoglobin and malondialde-hyde levels in the observation group were lower than those in the control group,while the levels of pH,bicarbonate ion,car-bon dioxide binding capacity,superoxide dismutase,total antioxidant capacity,glutathione peroxidase and IRS-1,PI3K and GLUT4 were higher than those of control group(P＜0.05).The incidence of hypoglycemia in the observation group was 6.67%(2/30),which was lower than that in the control group[30.00%(9/30)](P＜0.05).Conclusion Continuous pumping of insulin with micropump combined with Octreotide has a definite effect on DKA,which can improve blood gas anal-ysis indexes and blood glucose levels in patients and effectively avoid hypoglycemia.This may be related to regulating IRS-1/PI3K/GLUT4 insulin metabolic pathway and alleviating oxidative stress.关键词
糖尿病酮症酸中毒/奥曲肽/胰岛素/微量泵/血糖/超氧化物歧化酶/丙二醛/低血糖Key words
Diabetic ketoacidosis/Octreotide/Insulin/Micropump/Blood glucose/Superoxide dismutase/Malond-ialdehyde/Hypoglycemia分类
临床医学引用本文复制引用
李明,张立绘,翟晓丹,杨宽,王艳艳,刘红国..微量泵持续胰岛素泵入联合奥曲肽治疗糖尿病酮症酸中毒的作用机制研究[J].临床误诊误治,2023,36(8):46-51,6.基金项目
河北省医学科学研究课题计划项目(20211713) （20211713）
张家口市重点研发计划项目(2021130H) （2021130H）
