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目的:评价胰岛素不同给药途径与哌拉西林-舒巴坦联用对2型糖尿病患者伴肺部感染的临床疗效及其对炎症因子的影响。方法:选取2016年2月—2017年2月期间医院收治的2型糖尿病患者伴肺部感染82例临床资料,将其随机分为对照组和观察组(每组41例);两组患者均给予采集痰液细菌培养与药敏试验,根据细菌培养和药敏试验结果给予注射用哌拉钠西林-舒巴坦钠治疗,在此基础上对照组患者加用门冬胰岛素30注射液每日三餐前30 min皮下注射治疗,观察组患者在抗感染治疗基础上采用胰岛素泵连续皮下给予门冬胰岛素30注射液治疗,比较两组患者治疗后的总有效率、不良反应的发生率以及治疗前后炎性因子水平与血糖控制情况。结果:观察组患者治疗后的总有效率为95.12%高于对照组为85.37%(P<0.05);两组患者治疗后的白介素-6(IL-6)、白介素-8(IL-8)与超敏C-反应蛋白(hs-CRP)值均明显低于治疗前(P<0.05);观察组患者治疗后IL-6、IL-8与hs-CRP值均明显低于对照组(P<0.05)。结论:采用门冬胰岛素30注射液胰岛素泵连续皮下给药配合哌拉西林-舒巴坦联用治疗2型糖尿病患者伴肺部感染,临床疗效优于多次皮下注射胰岛素与哌拉西林-舒巴坦联用治疗,显著改善了的炎性因子值,有效地控制血糖。
OBJECTIVE: To evaluate the clinical efficacy of different routes of administration of insulin and piperacillin-sulbactam in patients with type 2 diabetes with pulmonary infection and its effect on inflammatory cytokines. Methods: 82 patients with type 2 diabetes mellitus and pulmonary infection admitted to the hospital from February 2016 to February 2017 were selected and randomly divided into control group and observation group (41 cases in each group). Both groups Given sputum bacterial culture and drug susceptibility testing, according to the results of bacterial culture and susceptibility test given piperacillin-sulbactam sodium injection, on the basis of the control group patients with insulin aspart 30 injection daily Subcutaneous injection of 30 min before meals, the observation group patients on the basis of anti-infective therapy with insulin pump continuous subcutaneous administration of insulin aspart 30 injection treatment, the two groups were compared the total effective rate after treatment, the incidence of adverse reactions and treatment Before and after the level of inflammatory cytokines and blood sugar control. Results: After treatment, the total effective rate in observation group was 95.12%, which was higher than that in control group (85.37%, P <0.05). The levels of IL-6, IL- (Hs-CRP) were significantly lower than those before treatment (P <0.05). The levels of IL-6, IL-8 and hs-CRP in the observation group were significantly lower than those in the control group <0.05). CONCLUSION: Aspirin 30 injection with continuous subcutaneous injection of insulin pump in combination with piperacillin-sulbactam for the treatment of type 2 diabetes with pulmonary infection is superior to multiple subcutaneous injections of insulin and piperacillin-Shu Bata Tan combined treatment, significantly improved the value of inflammatory factors, effective control of blood glucose.