目的：探讨干预胰岛素使用和自我血糖管理在囊性纤维化相关性糖尿病（CFRD）治疗中的作用。方法：选择上海市14 家

医院2007 年4 月－2013 年4 月CFRD住院患者1 295 例，采用前瞻性队列研究，分为试验组（743 例）与对照组（552 例）。对照组患

者维持胰岛素注射剂量，试验组患者每周调整胰岛素注射剂量并行自我血糖管理宣教。检测记录并比较干预后1 年两组患者的

血糖数据、血脂水平、生活质量、自我管理能力等指标。结果：干预后1 年随访时，试验组患者的空腹血糖、餐后2 h 血糖、糖化血红

蛋白明显低于对照组，差异均有统计学意义（P＜0.05）；试验组患者的血糖达标时间、胰岛素使用剂量、高血糖次数、低血糖次数均

明显短/少于对照组，差异均有统计学意义（P＜0.05）；试验组患者的血糖达标率[93.5％（695/743）]与对照组[59.6％（329/552）]比较

差异有统计学意义（χ2＝18.509，P＜0.05）；试验组患者的甘油三酯降低，高密度脂蛋白升高，与对照组比较均有统计学意义（P＜

0.05）；试验组患者的生活质量量表评分（196.24±15.80）与对照组（180.33±16.29）比较差异有统计学意义（P＜0.05）；试验组患者

的自我管理能力均高于对照组，差异有统计学意义（P＜0.05）。结论：干预胰岛素使用和自我血糖管理能够有效控制CFRD患者

的血糖水平，提高其生活质量、用药依从性及治疗效果。

OBJECTIVE：To investigate the effect of insulin use intervention and self management of blood glucose in the treatment

of cystic fibrosis related diabetes. METHODS：In prospective cohort study，during Apr. 2007-Apr. 2013，1 295 CFRD inpatients

selected from 14 hospitals of Shanghai were randomly divided into trial group（743 cases）and control group（552 cases）.

Control group maintained the dose of insulin，and trial group adjusted the dose of insulin every week and received patient education

about self management of blood glucose. Blood glucose，blood lipid，quality of life，the ability of self management and other index

were detected，recorded and compared between 2 groups 1 year after intervention. RESULTS：1 year after intervention，fasting

blood glucose，postprandial 2 h blood glucose and HbA1c of trial group were significantly lower than those of control gorup，with

statistical significance（P＜0.05）. The time of blood glucose reaching the standard，the dose of insulin，the number of hyperglycemia

and hypoglycemia in trial group were all significantly shorter or lower than control group，with statistical significance（P＜0.05）.

There was statistically significant difference in the rate of standard blood glucose between trial group [93.5％（695/743）] and control

group [59.6％（329/552）]. TG of trial group decreased while HDL increased，there was statistically significant difference between 2

groups（P＜0.05）. There was statistically significant difference in the quality of life score between trial group（196.24±15.80）and

control group（180.33±16.29）（P＜0.05）. The ability of self management in trial group was significantly higher than control group，

with statistical significance（P＜0.05）. CONCLUSIONS：Insulin use intervention and self management of blood glucose can control

the level of blood glucose in CFRD patients，and improve the quality of life，medication compliance and therapeutic effect.