2型糖尿病合并心肌梗死患者血糖监测系统和胰岛素泵的应用

目的探讨动态血糖监测系统和胰岛素泵在糖尿病合并心肌梗死患者的应用疗效。方法将50例2型糖尿病合并心肌梗死患者随机分为3组：组1采用动态血糖监测系统（CGMS）与胰岛素泵（CSII）结合治疗模式（双C组,16例）,组2采用单纯胰岛素泵治疗（CSII组,17例）,组3采用胰岛素多次注射治疗（MSII组,17例）,后两组采用指端毛细血糖监测法,治疗7d后比较三组血糖控制情况、血糖达标率及血糖漂移情况。结果治疗7天后双C组和CSII组患者的全日血糖、平均血糖（MBG）、平均血糖波动幅度（MAGE）均较治疗前明显下降（p〈0.05）,明显优于MSII组（p〈0.05）,低血糖发生次数亦较MSII组明显减少（p〈0.05）。其中双C组MBG、MAGE、低血糖次数均显著低于CSII组（p〈0.05）。结论胰岛素泵强化治疗可有效控制血糖,动态系统监测系统能监测血糖连续的变化曲线,及时发现高血糖和低血糖,与胰岛素泵联合治疗更有利于心肌梗死患者血糖的控制,降低低血糖的发生率。

Application of Continuous Glucose Monitoring System and Continuous Subcutaneous Insulin Infusion Pump System in Type 2 Diabetic Patients combined with Acute Myocardial Infarction

Objective To investigate the therapeutic effect of continuous glucose monitoring system（CGMS） and continuous subcutaneous insulin infusion pump system（CSII） in type 2 diabetic patients combined with acute myocardial infarction（AMI）.Methods 50 cases of type 2 diabetic patients combined with AMI were randomly divided into three groups：CGMS＋CSII group of 16 patients used CGMS to monitor blood glucose changes as well as using CSII to control blood glucose. CSII group of 17 patients only used CSII,while MSII group received multiple injections of insulin therapy, which both used the tip of finger capillary blood glucose meters to monitor blood glucose.The changes of controlled blood glucose,the mean blood glucose（MBG）, mean amplitude of glycemic excursions（MAGE） and the number of hypoglycemia were compared among three groups after 7 days-treatment. Results After 7 days-pump therapy, the whole day glucose, MBG and MAGE were all significantly lower than those before treatment （p〈 0.05）, and significantly better than MSII group as well as the number of hypoglycemia （p〈0.05）. Besides, the MBG, MAGE and hypoglycemia event times of CGMS＋CSII group were obviously less than CSII group （p 〈 0.05）. Conclusion CSII can control the blood glucose efficiently. CGMS can depict a continuous blood glucose curve, and discover hyperglycemia or hypoglycemia timely. CGMS combined with CSII are more beneficial to the glucose control of the patients with AMI, and the decreasing of hypoglycemia events.