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在住院COVID-19患者中管理类固醇诱导高血糖症的最佳初始胰岛素剂量:一项回顾性单中心研究
Nuttavadee Ketaroonrut1, Sasisopin Kiertiburanakul1, Chutintorn Sriphrapradang1
1Faculty of Medicine, Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
在COVID-19患者中确定类固醇诱导高血糖症的最佳初始胰岛素剂量至关重要. 建议个性化的胰岛素剂量,因为更高的剂量增加了低血糖的风险,而没有改善血糖控制.
科学领域:
- 内分泌学 在内分泌学.
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 类固醇,如甲,用于治疗COVID-19,但可能导致高血糖症.
- 在COVID-19患者中管理类固醇诱导的高血糖症需要仔细选择胰岛素剂量.
- 这种患者群体的最佳初始胰岛素策略尚未得到充分确立.
研究的目的:
- 确定最佳的初始胰岛素剂量,以控制接受类固醇的COVID-19患者的高血糖症.
- 评估初始胰岛素剂量与治疗失败率之间的关系.
- 评估不同初始胰岛素剂量的低血糖的发生率.
主要方法:
- 对156名COVID-19患者的回顾性分析,这些患者患有类固醇诱导的高血糖症.
- 根据最初的每日皮下胰岛素总剂量 (单位/千克) 将患者分为四组.
- 治疗失败的定义是持续的高血糖症或血糖水平极高.
主要成果:
- 在胰岛素剂量组B (0.3-0.49单位/千克),C (0.5-0.69单位/千克) 和D (≥0.7单位/千克) 之间,治疗失败率没有显著差异.
- 组A (≤0.29单位/公斤) 显示治疗失败率最低.
- D组的轻度低血糖率显着更高 (一级).
结论:
- 对于服用高剂量类固醇的COVID-19患者,初始胰岛素剂量为0.3单位/千克/天或更高,治疗失败率没有显著差异.
- 较高的初始胰岛素剂量 (D组) 与轻度低血糖的增加有关.
- 建议在住院COVID-19患者中进行个性化胰岛素剂量选择,以管理类固醇诱导的高血糖症.
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