3C在住院患者血糖管理中的应用.ppt

一、胰岛素泵（CSII)工作原理： 二、CGM——动态血糖监测系统 SG和BG相关性较好 、 患者血糖总趋势图 RT-CGM 小结 1： 具有实时动态血糖显示功能，患者随时可以观察血糖变化，提升信心，增强治疗依从性，并总结其生活方式的变化对血糖的影响，逐渐改变不良的生活方式 3 具有血糖高低值报警系统，能增加胰岛素治疗安全性，减少低血糖、高血糖危象发生 2 患者血糖、胰岛素基础率、大剂量等一目了然，方便临床调整治疗方案 4 利用实时动态血糖监测系统，掌握血糖特点，分析影响血糖可能因素，使血糖平稳达标 * 美敦力722实时动态胰岛素泵系统创新性的将实时动态血糖监测、胰岛素输注与糖尿病综合管理软件整合在了一起，成为全球第一个“3C”整合系统,能够帮助糖尿病医生快速、安全、精准地达到血糖控制目标。 CSII CGM CareLink信息包括： 胰岛素输注信息、血糖仪血糖信息、探头血糖信息 进食CHO量、报警信息等 * * Glucose sensor electrochemistry: Glucose and oxygen is present in body fluid – glucose at a much higher ratio than oxygen.(葡萄糖氧化酶) To overcome ratio difference, semi-permeable membrane equalizes concentrations of glucose and oxygen. Glucose Oxidase enzyme catalyzes reaction between glucose and oxygen to produce peroxide. Peroxide is oxidized, producing electrons that are measured as the sensor signal. The Sensor is a platinum electrode coated with glucose oxidase. The electrode is covered with a semi permeable membrane. Once the sensor is inserted into the skin, it is bathed in interstitial fluid. The electrodes must get wet prior to beginning the initialization process. Glucose oxygen from the interstitial fluid diffuses across the semi-permeable membrane (allows more O2 to enter than glucose) Once across the membrane, glucose oxygen react with the enzyme (glucose oxidase) on the electrode/ sensor Glucose oxygen react with the enzyme catalyst, glucose oxidase, to produce Hydrogen Peroxide Gluconic Acid Peroxide diffuses through the glucose oxidase enzyme layer to the electrode where an applied voltage breaks H2O2 into hydrogen and oxygen; an electrical signal (2e-) is produced, called ISIG * In summary – these are the essential components in measure glucose using Medtronic’s sensor. AS ISIG increases, the sensor glucose value increases, and this is in relationship to the amount of hydrogen peroxide at the electrode. More glucose produces more peroxide and the more peroxide present, the more current is present at the electrode The ISIG conv