复方倍他米松局部给药镇痛治疗对糖尿病患者血糖水平的影响*

THE BLOOD GLUCOSE CHANGES OF LOCALLY INJECTING BETAMETHASONE ANALGESIA IN PATIENTS WITH DIABETES MELLITUS*

摘要:

目的：研究复方倍他米松局部给药镇痛治疗对糖尿病患者血糖变化及影响因素。方法：以2020年1月至2021年4月经复方倍他米松局部治疗的疼痛伴糖尿病患者为研究对象，比较治疗前后空腹血糖、睡前血糖变化和疼痛缓解程度，分析年龄、性别、BMI、糖尿病病程、用药部位、空腹血糖水平等因素对血糖影响。结果：与治疗前相比，治疗后视觉模拟评分法评分显著降低（P<0.001）。空腹血糖和睡前血糖分别升高2.93±3.94mmol/L和3.78±3.96 mmol/L（P<0.001），次日血糖水平均呈下降趋势，变化值分别为-1.23±2.67mmol/L和-1.41±4.19mmol/L（P<0.05）。单因素和多因素分析结果显示，糖尿病病程是空腹血糖波动的影响因素，性别是睡前血糖波动的影响因素。结论：复方倍他米松局部给药镇痛治疗可引起糖尿病患者血糖短暂性波动。临床医师应尤其关注并监测女性、病史长的糖尿病患者血糖水平。

Abstract:

Objective：To investigate the changes of blood glucose in patients with diabetes mellitus after a single dose of local analgesia with betamethasone, and to analyze the related factors. Methods: Pain and DM patients who received nerve block with betamethasone from January 2020 to April 2021 were included. The visual analogue scales (VAS), fasting blood glucose (FBG), fasting blood glucose (BBG) were analyzed before and after treatment, and the influence on the changes of blood glucose by age, gender, BMI, diabetes duration, location of injection and basal glucose control in patients were explored. Results: After treatment, VAS scores decreased significantly(P<0.001). Fasting and bedtime blood glucose increased by 2.93±3.94mmol/L and 3.78±3.96 mmol/L respectively (P<0.001), and decreased the next day with the changes of -1.23±2.67mmol/L and -1.41±4.19mmol/L respectively(P<0.05). Univariate and multivariate analysis showed that diabetes duration was the influencing factors of FBG fluctuation, while gender was the influencing factor of BBG fluctuation. Conclusion: Local administration of analgesia with betamethasone may cause transient fluctuation of blood glucose in diabetic patients. Clinical attention should be paid to monitoring the blood glucose levels, especially for patients who are females and have long diabetes durations.