2020 年第 2 期 第 15 卷

胰岛素泵治疗儿童1型糖尿病临床效果及安全性的Meta分析

Efficacy and safety of insulin pump in treatment of type 1 diabetes mellitus in children: a meta analysis

作者：吕建军厉红刘小娜白晶

英文作者：

单位：河北省唐山市妇幼保健院小儿内分泌科063000

英文单位：

关键词：1型糖尿病；胰岛素泵；胰岛素多次皮下注射；Meta分析

英文关键词：

• 摘要：

• 【摘要】目的    探究胰岛素泵治疗儿童1型糖尿病的临床效果及安全性。方法    计算机检索1995年1月至2018年2月在中国期刊全文数据库、万方数据库、维普中文科技期刊全文数据库、中国生物医学文献数据库、EMBase及Cochrane Library等中英文数据库发表的关于胰岛素泵与胰岛素多次皮下注射治疗1型糖尿病的文献，主要观察指标包括血糖达标时间、胰岛素用量及低血糖发生率。对纳入文献进行方法学质量评价，应用RevMan 5.2软件对2组患儿血糖达标时间、胰岛素用量及低血糖发生率进行Meta分析。结果    按照纳入与排除标准最终纳入8篇文献，经文献质量评价，2组患儿基本资料具有可比性、研究数据明确可靠，均为B级质量。共564例患儿，其中观察组280例，对照组284例，观察组血糖达标时间短于对照组（P＜0.000 01，均数差=-1.73，95%置信区间：-1.97~-1.49）,胰岛素用量低于对照组（P＜0.000 01，均数差=-10.32，95%置信区间：-11.19~-9.45）,低血糖发生率低于对照组（P＜0.000 01，率差=-0.20，95%置信区间：-0.27~-0.14）。结论    胰岛素泵治疗儿童1型糖尿病临床效果确切，可缩短血糖达标时间、减少胰岛素用量、降低低血糖发生率。

• 【Abstract】Objective    To explore the clinical effect and safety of insulin pump in treatment of children with type 1 diabetes mellitus. Methods    Literatures regarding insulin pump versus multiple subcutaneous insulin injection（MSII） treating type 1 diabetes mellitus in children published between January 1995 to February 2018 were retrieved from Chinese Journal Full-text Database, Wangfang Data, VIP Chinese Sci-tech Periodical Full-text Database, China Biology Medicine disc, EMBase and Cochrane Library. Major outcome indicators included blood glucose compliance time, insulin consumption and the incidence of hypoglycemia. Methodological quality of literatures was assessed. RevMan 5.2 software was used for meta analysis. Results    Eight literatures（quality grade B） involving 564 children with type 1 diabetes mellitus were analyzed in this study, including 280 cases treated with insulin pump and 284 cases treated with insulin pump. Meta analysis showed that blood glucose compliance time with insulin pump was shorter(P＜0.000 01, mean difference=-1.73, 95% confidence interval=-1.97--1.49), insulin consumption was less(P＜0.000 01, mean difference=-10.32, 95% confidence interval=-11.19--9.45) and the incidence of hypoglycemia was lower as compared with MSII(P＜0.000 01, risk difference=-0.20, 95% confidence interval=-0.27--0.14). Conclusion    Insulin pump is effective in treating children with type 1 diabetes mellitus; it can promote blood glucose recovery, reduce insulin dose and prevent hypoglycemia.