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首页|期刊导航|内科理论与实践|优化胰岛素用量在垂体功能减退患者生长激素刺激试验中的应用效果研究

优化胰岛素用量在垂体功能减退患者生长激素刺激试验中的应用效果研究

江淳弘 史佳

内科理论与实践2025,Vol.20Issue(2):157-161,5.
内科理论与实践2025,Vol.20Issue(2):157-161,5.DOI:10.16138/j.1673-6087.2025.02.10

优化胰岛素用量在垂体功能减退患者生长激素刺激试验中的应用效果研究

Effect of optimizing insulin dosage in insulin-induced hypoglycemia-growth hormone stimulation test in patients with hypopituitarism

江淳弘 1史佳1

作者信息

  • 1. 上海交通大学医学院附属瑞金医院内分泌与代谢病科,上海 200025
  • 折叠

摘要

Abstract

Objective To investigate the effect of optimizing calculation method of insulin dosage in hypoglycemia growth hormone stimulation test[insulin tolerance test(ITT)]in patients with hypopituitarism.Methods Totally 106 patients with hypopituitarism admitted from February 2021 to March 2023 were selected for ITT,including 79 males and 27 females aged 14 to 61 years.Insulin dosage obtained by insulin optimization formula was used in the test,which is,insulin dosage(U)=body weight×{-0.034+0.000 176×[0.5×(fasting insulin+180 min insulin)+60 min insulin+120 min insulin]+0.009 846×body mass index(BMI)}.The blood glucose changes of patients were monitored 30 min before the test,immediately after intravenous infusion and 30,45,60,90 and 120 min after intravenous infusion,respectively,and the main complaints of patients were recorded.Results All 106 patients completed the test without any severe clinical reactions such as hypoglycemic coma or pituitary crisis.Among them,76 patients(71.70%)experienced hypoglycemia within 30 min after the start of the test,22 patients(20.75%)experienced hypoglycemia at 45 min,and the remaining 8 patients(7.55%)did not achieve a successful stimulation response.Comparison of the area under the glucose curve(AUCGlu)among the 106 patients revealed that patients with simultaneous deficiencies in two hormones(growth hormone and cortisol)had lower overall blood glucose levels than those with a single hormone(growth hormone)deficiency.All patients'blood glucose levels returned to normal by the end of the test.Conclusions The use of an optimized insulin dosage calculation method in ITT results in an earlier onset of hypoglycemia.This underscores the importance of thorough pre-test assessment by nurses,close monitoring of patients'subjective complaints and blood glucose levels during the test,and proper nursing care to ensure the safety and success of the procedure.

关键词

胰岛素耐量试验/生长激素刺激试验/垂体功能减退/低血糖/护理

Key words

Insulin tolerance test/Growth hormone stimulation test/Hypopituitarism/Hypoglycemia/Nursing

分类

医药卫生

引用本文复制引用

江淳弘,史佳..优化胰岛素用量在垂体功能减退患者生长激素刺激试验中的应用效果研究[J].内科理论与实践,2025,20(2):157-161,5.

内科理论与实践

1673-6087

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