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目的 比较短期胰岛素泵连续皮下胰岛素输注(CSⅡ)和静脉连续胰岛素输注(CVⅡ)在老年糖尿病酮症(DK)治疗中的临床效益.方法 120例老年DK患者分为CSⅡ组和CVⅡ组,各60例,对比两组临床治疗效益及成本效益.结果 CSⅡ组与CVⅡ组比较,血糖达标时间[(6.28±1.6)d]vs[(9.68±1.8)d]、β-羟丁酸恢复正常时间[(17.0±3.8)h]vs[(31.3±6.4)h]、胰岛素用量[(43.8±7.8)u/d]vs(54.9±6.8)u/d]、低血糖发生率[(0.56±0.34)次/例]vs(1.62±0.54)次/例]、注射成本(人民币元)[(459.56±35.34)元]vs[(291.62±40.54)元],每日成本[(446.8±37.8)元)]vs[(245.9±6.8)元],总成本[(3567.50±73.82)元)]vs[(4131.53±86.42)元],两组比较均有显著性差异(P<0.05),3个月后糖化血红蛋白(HbA1>c)和胰岛素用量差异仍有显著性.结论 CSⅡ组治疗方案相对较优,且有较佳的中长期效果.

Objective To compare the clinical benefit between continuous subcutaneous insulin infu-sion(CSⅡ) and continuous intravenous insulin infusion (CVⅡ) in treatment of elderly patients with diabetic ketoaciduria. Methods 120 elderly patients with diabetic ketoaciduria were randomized into two groups, one was CSⅡ group by a portable insulin pump(60 cases), the other was CVⅡ group (60 cases), and compare two grouds on the clinical therapeutic benefit and cost benefit. Results The glucose level, therapeutic time [(6.28±1.6) dvs (9.68±1.8) d]; the time to normal ketonuria [(17.0±3.8) hvs (31.3±6.4)]; insulin dosage [(43.8±7.8) u/d vs (54.9±6.8) u/d], the rate of hypoglycemia [(1.62±0.54)vs(0.56±0.34)] were better than CVⅡ, and expense (RMB Yuan) [(446.8±37.8)]vs [(245.9±6.8)], mean cost (RMB Yuan) [(446.8±37.8))] vs [(245.9±6.8)]) were greater than CVⅡ, while the total cost (RMB Yuan) [(3567.50±73.82)]vs[(4131.53±86.42)] was less than CVⅡ,The insulin dosage and HbA1>c of CSⅡ group were significantly lower CSⅡ group after 3 months. Conclusion This study shows that CSⅡ is the refera-ble one for the elderly patients with diabetic ketoaciduria, and the efficacy last longer to medium-or long-term.