中国全科医学 ›› 2020, Vol. 23 ›› Issue (34): 4342-4348.DOI: 10.12114/j.issn.1007-9572.2020.00.420

所属专题: 中医最新文章合集

• 专题研究 • 上一篇    下一篇

胰岛素针头使用次数与皮下脂肪增生发生关系的网状Meta分析

张伟1,朱冬梅1,费朝廷1,周明2*   

  1. 1.212013江苏省镇江市,江苏大学医学院 2.212000江苏省镇江市第一人民医院新区分院
    *通信作者:周明,副主任医师;E-mail:zhouming5808088@126.com
  • 出版日期:2020-12-05 发布日期:2020-12-05
  • 基金资助:
    中国学位与研究生教育课题阶段性成果(C-YX20190201-08);江苏省学位与研究生教育课题(XYH050)

Relationship between the Use Frequency of Insulin Needles and Lipohypertrophy:a Network Meta-analysis 

ZHANG Wei1,ZHU Dongmei1,FEI Chaoting1,ZHOU Ming2*   

  1. 1.School of Medicine,Jiangsu University,Zhenjiang 212013,China
    2.Zhenjiang First People's Hospital Branch,Zhenjiang 212000,China
    *Corresponding author:ZHOU Ming,Associate chief physician;E-mail:zhouming5808088@126.com
  • Published:2020-12-05 Online:2020-12-05

摘要: 背景 皮下脂肪增生是糖尿病患者注射胰岛素的常见并发症。由于“重复使用”的概念较为宽泛,目前研究对重复使用针头是否与脂肪增生发生有关的结论并不一致。目的 评价胰岛素针头使用次数与发生皮下脂肪增生的关系。方法 于2018年3—11月,检索PubMed、循证医学数据库(Cochrane Library)、荷兰医学文摘(EMBase)、Science Direct、中国生物文献数据库(CMB)、中国知网(CNKI)等主要数据库,收集胰岛素注射针头使用不同频次(1、2~3、4、5、6~10次)与脂肪增生发生相关的流行病学和实验性研究,并对纳入的研究进行质量评价和数据的提取,检索均从建库至2018年10月,采用Stata 15.0进行网状Meta分析。结果 不重复使用针头组脂肪增生的发生概率最低(10.1%);重复使用针头2~10次组间脂肪增生发生情况比较,差异无统计学意义(P>0.05);与不重复使用针头组相比,重复使用针头6~10次组患者脂肪增生发生率明显上升〔OR=3.72,95%CI(1.05,13.17),P<0.05〕。重复使用针头1~5次组间脂肪增生发生情况比较,差异无统计学意义(P>0.05)。结论 优先推荐一次性使用胰岛素针头,如因条件限制不能做到一针一换,针头使用次数不应超过5次。

关键词: 糖尿病, 胰岛素, 针头, 重复使用, 脂肪增生

Abstract: Background Lipohypertrophy is a common complication of insulin injection in diabetic patients.Current studies have not been consistent on whether there is a relationship between repeated use of needles and the occurrence of lipohypertrophy,since the conception of "reuse" is too broad. Objective The purpose of this study is to evaluate the relationship between use frequency of insulin needles and the occurrence of lipohypertrophy. Methods From March to November,2018,databases of PubMed,Cochrane Library,EMBase,Science Direct,CMB,and CNKI were searched from inception to October 2018 for collecting epidemiological and experimental studies on the relationship between lipohypertrophy and times (1,2-3,4,5,6-10) of use of insulin injection needles. Quality evaluation and data extraction of the included studies were performed. Network meta-analysis was performed using Stata15.0. Results Patients who did not reuse insulin injection needles had the lowest incidence of lipohypertrophy(10.1%). There was no significant difference in the incidence of lipohypertrophy among patients reusing the needles 2-10 times(P>0.05). The incidence of lipohypertrophy rose significantly in those reusing needles 6-10 times compared with that of those without reuse behaviors〔OR=3.72,95%CI(1.05,13.17),P<0.05〕. The incidence of lipohypertrophy was not significantly different across patients who used needles 1-5 times(P>0.05). Conclusion Disposable insulin needles are highly recommended. If such needles are not available due to limited medical resources or other factors,the times of reusing needles should not exceed 5.

Key words: Diabetes, Insulin, Needles, Reuse, Lipohypertrophy