. .
.., .., __, ..
, . . , , , . . , - .
. , , , .
(), , - . , , , . ( ), , .
() (A. Kadesh) 1963 Whitehall Laboratories (. 1). , , . (), (Albisser et al., 1974; Pfeiffer et al., 1974). (), (~80x60x40 ) (~16 ).
. 1. Arnold Kadesh .
1977 . , ( ) Auto Syringe. AS2C (. 2).
. 2. Auto Syringe AS2C. 6,3518,37,2 , 482 . : 1, 2 4 . 30 . , . .
1983 Auto Syringe AS2MP (. 3).
. 3. Auto Syringe AS2MP. 7,116,08,7 , 286 . 1-3 . U40 U100. 0,1-36,6 /. (- 24 16 , 2 ). 24 .
80- XX BioStar (Biostator Artificial Pancreas), , (. 2). , , 5 , , .
. 2.
BioStar (Biostator
Artificial Pancreas:
, , , .
, , 1973 (Dean Kamen). , . 1978 15 .
1978 1987 , (. 3). , : .
. 3. , 19781987 .
, ( ), . - . , , .
XX XXI , : ( ); ; . (. 4.).
. 4. .
1999
,
( ) CGMS (Continuing Glucose Monitoring System).
, 5
, ,
Guardian Real-Time.
CGM-RT. 2006
, +
Medtronic Paradigm Real-Time 722 (. 5.).
b
d
e
. 5. : a CGMS; b Guardian; c Paradigm Real-Time; d Dexcom; e FreeStyle Navigator.
( ) : . , , , .
?
(
),
(), .
.
, , .
;
52%.
, .
.
( 3%) [1, 2].
.
-,
,
.
.
, ,
, .
,
.
.
10 , -
(0,1 ).
.
. ,
, -
,
.
,
. ,
.
?
, ,
, -.
( , ) 3 .
.
4 .
.
.
! . ,
,
( ) .
.
1-, 2- .
: 80%
1 70%
.
: 20062007
1000 , 2008 ~1500 ,
2009 ~3500 , 2010
>6500 .
, [3]. ,
( HbA1c)
( 70%
), [4, 5, 6].
(
) [5] .
.
(,
),
.
.
3 ,
. ( !) ,
- (, , , ).
, , :
.
, ().
, 35 , , . , ( ), , .. ( ) ( 0,0250,100 , ) (, 0,60 / 0,05 5 0,025 150 ). . , 12:00 12:30 0,80 /, 12:30 13:00 1,10 / .
. 1.
( ) (
) .
. .
- .
-
12
( , ).
, .
, ,
. , ,
.
, ,
, (
), ,
. ,
52% [2]. (
) (
).
3%.
, -.
.
.
.
0,1 ( 1,0 -).
0,0250,100 !
.
1 3 ,
15 .
.
.
, ,
( ,
, .),
,
.
.
.
,
( ) . ,
,
.
. CGM-RT
.
,
. ,
, - .
(
).
, , . 16
. (
) ,
, CGM-RT.
, , , ,
, ,
. ,
, , ,
, ..
1
,
,
;
2
,
0,1 ;
3
;
4
, (CGM-RT)
.
-
,
.
-,
.
,
,
,
( , ,
,
-
). 23
, ,
.
.
,
,
.
(
2-3 ),
.
,
, , .
,
- .
,
.
,
.
|
Medtonic MiniMed |
Roche Accu-Chek |
Sooil |
|||||
|
Paradigm
712/512 |
Paradigm
Real-Time 722/522 |
Paradigm Veo 754/554 |
D-Tron plus |
Spirit |
Combo |
Dana diabecare R |
|
|
2 |
3 |
4 |
1 |
1 |
2 |
2 |
2 |
- |
||||||||
, |
103/83 |
103/83 |
103/83 |
125 |
85 |
110 |
65 |
65 |
, |
50.8x91.4x20.3 |
50.8x91.4x20.3 |
50.8x91.4x20.3 |
1054821 |
80x47x24 |
81x55x20 |
46x77x19 |
46x77x19 |
|
|
) |
|
|||||
|
300/180 |
300/180 |
300/180 |
300 |
315 |
315 |
300 |
300 |
|
, |
, |
, |
|
|
|
|
|
|
+ |
+ |
+ |
+ |
+ |
+ |
+ |
|
|
0,05 |
0,05 |
0,025 |
0,1 |
0,1 |
0,05 |
0,01 |
0,01 |
|
30 |
30 |
30 |
60 |
60 |
60 |
60 |
60 |
|
3 |
3 |
3 |
1 |
5 |
5 |
1 |
1 |
|
1% 0,1 0 0,524 |
1% 0,1 0 0,524 |
1% 0,025 0 0,524 |
+ |
10% 0 200% 0,2524 |
10% 0 250% 0,2524 |
10% 0 200% 12 |
10% 0 200% 12 |
|
0,1 0,1, |
0,1 0,1, |
0,025 0,025, |
0,1 |
0,1, 0,2, 0,5, 1,0, 2,0 , |
0,1, 0,2, 0,5, 1,0, 2,0 , |
0,1, 0,5, 1,0 , |
0,1, 0,5, 1,0 , |
|
+ ( ) |
+ ( ) |
+ ( ) |
+ ( -) |
+ |
+ ( -) |
||
|
, , |
, , |
, , |
, |
, , |
, , |
, , |
, , |
|
(30 /) |
(30 /) |
(40 /) |
(5 /) |
(5 /) |
(15 /) |
(12 /) |
(12 /) |
, |
ٸ AAA, |
ٸ AAA, |
ٸ AAA, |
, |
ٸ , AA, |
ٸ , AA, 410 ; |
(1/2 AA 3,6V), |
(1/2 AA 3,6V), |
(/ ) |
3 /25 |
3 /25 |
3 /25 |
30 /1 |
3 /7 |
3 /7 |
500 , , 100 |
500 , , 100 |
|
CareLink
Pro; |
CareLink
Pro; |
CareLink
Pro; |
SmartPix; |
SmartPix; |
SmartPix; |
|
|
(CGM-RT) |
|
+ |
+ |
|
|
|
|
|
|
. |
. |
. |
|
|
|
|
|
|
+ |
+ |
+ |
+ |
+ |
|||
|
|
|
|
+; |
; |
+; |
||
|
4 ; |
4 ; |
4 ; |
2 ; 2 |
4 ; 6 |
6 ; |
4 ; |
4 ; |
|
|
|
IPX 8 (60 2,5 ) |
, . , , . , .
, . ( , ), . , , , (. ). 2 .
, (, , ) . .
1. (
). ,
. .
.
. ,
, ,
(, ,
- - ). D-Tron plus
( ,
).
2. . . , , , , ( , -). , , : , , . , , , . Roche Accu-Chek D-Tron plus Medtronic MiniMed 508 ( ) .
3. . , . ( ) , Medtronic Paradigm 712, , .. . , , . , ( , , , ). ( 56- , ) (, Sooil Dana).
4. , 1 . (0,1 ). , , . 0,1/ 0,05/ , (<20 /). , , . (, 0,025 /), . (0,01 /, ) Dana Diabecare IIS, IISG, R, Accu-Chek Combo. , , , 0,01 , . .
5. . , . 60 , . 30 , . 60 24 , 30 48. , 30 60 . .
6. . . . . , , , , , , , .. . . 3 Medtronic ( , ), 5 Sooil Accu-Chek.
7. . , . , . (, , 10 0, 100 ). 0,1 . : Accu-Chek Spirit, Accu-Chek Combo, Dana Diabecare II, IIS, IISG, R, Medtronic Paradigm 712/512, Real-Time 722/522, Veo 754/554.
8. . , ( ) , . , ( , , , ). , , 0,1 , , , . , 3,3 , - 3,0, 4,0 . Medtronic Paradigm, Dana Diabecare Accu-Chek Combo ( , ).
9. -, .
() .
() , .
(, ) .
, , , .. . .
10. . . . , ( ). , ( ) . Medtronic ( 554/754 1,5 ).
11. . () () . . , , . u-Chek Spirit Combo (), Medtronic , ( ) .
12. () . , , , , . , , (, Medtronic , 90 , 25 ). , , .
13.
. ()
.
, ,
, .
bluetooth,
(IR), (CareLink ComLink). Bluetooth
Dana Diabecare (
). IR Accu-Chek,
IR SmartPix
360 Diabetes Management System Adapter ( IR ). Medtronic Paradigm
CareLink USB
ComLink (
, , Com-,
).
,
. Dana Diabeticare
, . Accu-Chek SmartPix
360 Diabetes Management System. Medtronic
(CareLink Personal www.carelink.minimed.com);
(CareLink Pro,
, ).
14.
. Medtronic Paradigm REAL-Time (722/522) Veo (754/554)
.
,
. ,
(. !
һ).
15. .
.
,
- .
:
, , ,
(
) .
Medtronic Paradigm REAL-Time (722/522)
Veo (754/554)
. Medtronic Paradigm Veo
.
16.
.
, . Dana
Diabecare R Accu-Chek Combo
, (
). Medtronic Paradigm :
.
17.
. ,
.
Dana Diabecare R Accu-Chek Combo
, . :
-, . , -
Dana Diabecare R ( ).
Dana Diabecare IISG -
( -
). Medtronic
Paradigm :
. ,
(Contour Link
.).
18. . , . . , , , Accu-Chek D-Tron Spirit . .
19. . . , , . , 12 - . .
2. Lauritzen T,
Frost-Larsen K, Larsen HW, Deckert T, Keiding N, Nielsen G. Continuous
subcutaneous insulin // Lancet. 1983 Jun 25;1(8339):1445-6.
3. Doyle (Boland) EA,
Weinzimer SA, Steffen AT, et al. A randomized, prospective trial comparing the
efficacy of continuous subcutaneous insulin infusion with multiple daily
injections using insulin glargine // Diabetes Care 2004;27:15548.
4. Linkeschova R,
Raoul M, Bott U, et al. Less severe hypoglycaemia, better metabolic control,
and improved quality of life in type 1 diabetes mellitus with continuous
subcutaneous insulin infusion (CSII) therapy; an observational study of 100
consecutive patients followed for a mean of 2 years // Diabet Med
2002;19:74651.
5.
Weissberg-Benchell J, Antisdel-Lomaglio J, Seshadri R.
Insulin pump therapy: a meta-analysis // Diabetes Care 2003;26:107987.
6. Pickup JC. Are insulin pumps
underutilized in type 1
diabetes? Yes // Diabetes Care 2006;29:144952.
7.
Keenan
D.B., Cartaya R., Mastrototaro J.J.
Accuracy of a New Real-Time Continuous Glucose Monitoring Algorithm //
Journal of Diabetes Science and Technology 2010. V. 4, Issue
1. . 111118.
8. http://www.diabetesnet.com/diabetes-technology/insulin-pumps/current-pumps/pump-comparison
9. http://www.diabetesnet.com/diabetes-technology/infusion-sets
10. http://www.insulinpump.ru/pomoshh-v-vybore-insulinovoj-pompy/
Для цитирования:
Бочкова АГ. Рекомендации по ведению больных анкилозирующим спондилитом.По материалам Международной рабочей группы по изучению анкилозирующего спондилита(ASAS - Assesment Ankylosing Spondylitis Work Group). Современная ревматология. 2009;3(4):5-10. https://doi.org/10.14412/1996-7012-2009-566
For citation:
Bochkova AG. Rekomendatsii po vedeniyu bol'nykh ankiloziruyushchim spondilitom.Po materialam Mezhdunarodnoy rabochey gruppy po izucheniyu ankiloziruyushchego spondilita(ASAS - Assesment Ankylosing Spondylitis Work Group). Sovremennaya Revmatologiya=Modern Rheumatology Journal. 2009;3(4):5-10. https://doi.org/10.14412/1996-7012-2009-566
Просмотров HTML (Rus): 285