RESUMO
Objective To study the clinical efficacy of intensive insulin therapy (IIT) on patients with severe heart failure,pulmonary infection and hyperglycemia.Methods A retrospective analysis was studied on 104 patients with severe heart failure,pulmonary infection and hyperglycemia from January 2009 to August 2012,and 48 cases were treated by insulin conventional treatment (control group),while 56 cases were treated by IIT treatment (observation group).The blood glucose changes at each time and time of antibiotic using,pulmonary infection control situation and mortality rate between the two groups were observed and compared.Results The blood glucose before treatment in observation group and control group were (15.8 ± 4.3) and (15.3 ± 5.1) mmol/L,and there was no statistical difference (P ＞ 0.05).The blood glucose levels at 24,48,72 h and 1 week after treatment in observation group were (8.3 ± 2.1),(8.0 ± 1.2),(7.9 ± 1.3) and (7.9 ± 1.1) mmol/L,in control group were (12.5 ± 3.2),(11.7 ± 2.1),(11.3 ± 1.5) and (11.2 ± 1.7) mmol/L.The blood glucose levels after treatment in the two groups were significantly lower than those before treatment,but in observation group were significantly lower than those in control group,and there were statistical differences (P ＜0.01).The time of antibiotic using in observation group was significantly shorter than that in control group [(14.3 ± 2.5) d vs.(20.1 ± 3.2) d],and there was statistical difference(t =10.368,P ＜ 0.01).The total effective rate of pulmonary infection in observation group was significantly higher than that in control group [87.5％(49/56) vs.68.8％(33/48)],and there was statistical difference (x2 =5.448,P ＜ 0.05).The mortality rate in observation group was significantly lower than that in control group [8.9％ (5/56) vs.22.9％ (11/48)],and there was statistical difference (x2 =6.423,P ＜ 0.05).Conclusion The IIT used in the treatment of patients with severe heart failure,pulmonary infection and hyperglycemia can significantly improve the prognosis of patients and reduce mortality rate,which is worthy of clinical application.