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[患者教育的短期住院治疗——对Ⅰ型糖尿病患者代谢代偿的影响]

[Short-term hospitalization for patient education--effect on metabolic compensation in type I diabetics].

作者信息

Kvapil M

机构信息

I. interní klinika FN Motol, Praha.

出版信息

Vnitr Lek. 1996 Jan;42(1):12-6.

PMID:8629352
Abstract

The objective of the work was to evaluate the effect of short-term hospitalization on metabolic compensation in type 1 diabetics with an intensified insulin regime who are admitted to hospital with the main purpose to participate in an intense educational and therapeutic programme. Twenty patients were examined, mean age 26.3 +/- 6.5 years, mean duration of diabetes 13.2 +/- 8.0 years, who participated in a 5-day educational therapeutic programme which takes place in the authors' department. The level of metabolic compensation was evaluated at the onset and at the end of the hospitalization by means of fructosamine (F), mean blood sugar level, Michaelis index, MAGE (mean amplitude glycaemic excursion), the M value, MDD. During hospitalization in the whole evaluated group an average 6% drop of F was recorded. In the sub-group of patients with a baseline F > 2.6 mmol/l a statistically significant decline occurred from 2.91 +/- 0.14 mmol/l to 2.44 +/- 0.31 mmol/l (p < 0.05). The changes of different indexes calculated from the whole group did not reach statistical significance. In the sub-group with a poorer compensation (F > 2.6 mmol/l), however, the mean blood sugar level declined from 13.48 +/- 2.45 mmol/l to 9.17 +/- 2.05 mmol/l (p < 0.05) and the M value improved from 141.4 +/- 56.6 to 60.5 +/- 40.7 (p < 0.05). The MAGE index deterioration significantly during hospitalization only in the sub-group with a baseline F < 2.6 mmol/l from 2.70 +/- 1.11 to 3.65 +/- 1.28 (p < 0.05). The results indicate that in patients with type 1 diabetes mellitus short-term hospitalization with an educational therapeutic programme need not be associated with a deteriorated metabolic compensation. In those whose compensation is unsatisfactory marked improvement is recorded.

摘要

这项工作的目的是评估短期住院对1型糖尿病患者代谢补偿的影响,这些患者采用强化胰岛素治疗方案,因主要目的是参加强化教育和治疗项目而入院。对20名患者进行了检查,平均年龄26.3±6.5岁,平均糖尿病病程13.2±8.0年,他们参加了在作者所在科室开展的为期5天的教育治疗项目。通过果糖胺(F)、平均血糖水平、米氏指数、平均血糖波动幅度(MAGE)、M值、平均血糖标准差(MDD)在住院开始时和结束时评估代谢补偿水平。在整个评估组住院期间,记录到F平均下降了6%。在基线F>2.6 mmol/L的患者亚组中,F从2.91±0.14 mmol/L显著下降至2.44±0.31 mmol/L(p<0.05)。从整个组计算出的不同指标变化未达到统计学意义。然而,在补偿较差(F>2.6 mmol/L)的亚组中,平均血糖水平从13.48±2.45 mmol/L降至9.17±2.05 mmol/L(p<0.05),M值从141.4±56.6改善至60.5±40.7(p<0.05)。仅在基线F<2.6 mmol/L的亚组中,住院期间MAGE指数显著恶化,从2.70±1.11升至3.65±1.28(p<0.05)。结果表明,1型糖尿病患者短期住院并接受教育治疗项目不一定会导致代谢补偿恶化。对于那些补偿不满意的患者,有明显改善。

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