胰岛素泵治疗1型糖尿病患儿疗效的长期随访
[Long-term follow-up of efficacy of insulin pump in the treatment of children with type 1 diabetes mellitus].
作者信息
Yang Hong-Xiu, Leng Xue-Fei, Hu Si-Cui, Li Cheng, Qiao Ling-Yan, Chen Zhi-Hong, Li Tang
机构信息
Department of Pediatric Endocrinology, Qingdao Women and Children's Hospital, Qingdao, Shandong 266000, China.
出版信息
Zhongguo Dang Dai Er Ke Za Zhi. 2021 Feb;23(2):116-120. doi: 10.7499/j.issn.1008-8830.2009184.
OBJECTIVE
To study the clinical effect of continuous subcutaneous insulin infusion (CSⅡ) versus multiple daily injection (MDI) on blood glucose control in children with type 1 diabetes mellitus (T1DM).
METHODS
A retrospective analysis was performed on the medical data of 91 children with T1DM who were treated with CSⅡ for more than 1 year and 75 children with T1DM who were treated with MDI. The two groups were compared in terms of glycosylated hemoglobin (HbA1C) and the recurrence of diabetic ketoacidosis (DKA) to evaluate the difference in the efficacy during the 3-year follow-up. A survey was conducted for the children in the CSⅡ group and their family members to investigate the degree of satisfaction with insulin pump.
RESULTS
There was no significant difference in age, sex, and course of diabetes between the CSⅡ and MDI groups at disease onset and in the first year, the second year, and the third year of follow-up ( > 0.05). There was no significant difference in the HbA1C level between the two groups at disease onset ( > 0.05), but in the first year of follow-up, the CSⅡ group had a significantly lower HbA1C level than the MDI group (=0.04). There was no significant difference in the HbA1C level between the two groups in the second year and the third year of follow-up ( > 0.05). The CSⅡ group had a higher proportion of children with HbA1C < 7.5% than the MDI group in the first year, the second year, and the third year of follow-up ( > 0.05). Within the 3 years of follow-up, 2 children in the CSⅡ group and 8 in the MDI group experienced the recurrence of DKA. In the third year of follow-up, there was no significant difference in blood pressure and blood lipids between the CSⅡ and MDI groups ( > 0.05). Most children and their family members (87%) were satisfied with CSⅡ treatment.
CONCLUSIONS
Children with T1DM treated with CSⅡ have a better control of blood glucose than those treated with MDI, and children and their family members are satisfied with CSⅡ treatment. Therefore, it holds promise for clinical application.
目的
研究持续皮下胰岛素输注（CSⅡ）与多次皮下注射（MDI）对1型糖尿病（T1DM）患儿血糖控制的临床效果。
方法
对91例接受CSⅡ治疗超过1年的T1DM患儿和75例接受MDI治疗的T1DM患儿的医学资料进行回顾性分析。比较两组糖化血红蛋白（HbA1C）水平及糖尿病酮症酸中毒（DKA）复发情况，以评估3年随访期间疗效差异。对CSⅡ组患儿及其家庭成员进行调查，了解其对胰岛素泵的满意度。
结果
CSⅡ组和MDI组在发病时、随访第1年、第2年和第3年的年龄、性别及糖尿病病程方面无显著差异（>0.05）。两组发病时HbA1C水平无显著差异（>0.05），但随访第1年，CSⅡ组HbA1C水平显著低于MDI组（=0.04）。随访第2年和第3年两组HbA1C水平无显著差异（>0.05）。随访第1年、第2年和第3年，CSⅡ组HbA1C<7.5%的患儿比例高于MDI组（均>0.05）。随访3年内，CSⅡ组有2例患儿、MDI组有8例患儿出现DKA复发。随访第3年，CSⅡ组和MDI组血压及血脂无显著差异（>0.05）。大多数患儿及其家庭成员（87%）对CSⅡ治疗满意。
结论
接受CSⅡ治疗的T1DM患儿血糖控制优于接受MDI治疗的患儿，且患儿及其家庭成员对CSⅡ治疗满意。因此，其具有临床应用前景。
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