2型糖尿病患者治疗3年前后临床疗效对比分析  

Analysis of type 2 diabetic patients after a 3-year treatment

作　　者：姚晓爱[1] 许樟荣[2] 王玉珍[2] 焦凯[1] 伍春荣[2] 史琳涛[2] 胡莲娜[2] 倪彩虹[2] 

机构地区：[1]第四军医大学唐都医院内分泌科,陕西西安710038 [2]中国人民解放军第306医院糖尿病中心,北京100101

出　　处：《中国实用内科杂志》2007年第15期1196-1198,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的比较和分析2型糖尿病(T2DM)患者治疗3年前后的代谢和血压控制、胰岛B细胞功能变化及其与糖尿病并发症的关系。方法选择1993—2000年解放军第306医院糖尿病中心治疗3年的T2DM患者,测量身高、体重、腰围、臀围、卧立位血压,测定空腹及餐后2h血糖和胰岛素、糖化血红蛋白(HbA1c)、胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、肌酐(Cr)、尿微量白蛋白等和眼底检查,统计分析血糖、血脂和血压治疗达标率及相应的用药情况。结果T2DM患者治疗3年后应用的降血糖药物种类、降血压药物种类、调脂药物及胰岛素使用者的比例明显升高。HbA1c、HDL-C控制理想的病例从3年前的23%、69%升高到3年后的30%、76%;血压、TC、TG和LDL-C情况无明显改变;空腹及餐后胰岛素、胰岛素抵抗指数(HOMA-IR)明显下降,微量白蛋白尿的病例从3年前的15%增加到3年后的23%;眼底病变则由26%升高到33%。结论尽管T2DM患者使用降糖药、调脂药和胰岛素治疗的病例数明显增加,但3年治疗后代谢控制仍不满意,胰岛B细胞功能明显下降,眼底病和肾脏受损在加重,需要进一步重视T2DM治疗的全面达标。Objective To compare and analyze the metabolic control with the islet B cell function and the diabetic complications after a 3-year treatment in type 2 diabetic patients. Methods The T2DM patients were investigated who finished 3 years of treatment. The following measurements or determination was clone ： height, weight, waist, hips, blood pressure at standing and lying position ,fasting glucose and insulin, glucose and insulin 2 h after taking food, HbAI c,TC, TG, HDL-C, LDL-C, Cr, albuminuria and retinopathy. Results Totally 233 male and 178 female （56. 53 ± 10. 33 ）yrs patients were analysized. The hypotensive, hypoglycemic and lipids agents were increased obviously and the number of the patients with insulin treatment increased too. HbAI c was decreased,but no significant differences for the blood pressure and blood cholesterol,triglycerides after 3-year treatment. The fasting and post-meal insulin level, insulin resistance and the B-cell function index decreased significantly. Meanwhile,the patients with albuminuria and retinopathy increased from 15% and 26% to 23% and 33%. Condusion Type 2 diabetic patients have not controlled the blood glucose,lipids and the blood pressure satisfactorily even if the agents for the blood sugar,lipids and blood pressure lowing are increased. Insulin resistance decreases but B cell function failure aggravates. The intensified therapy on the target should be paid more attention to.

关 键 词：糖尿病 非胰岛素依赖型 代谢控制 达标 

分 类 号：R5[医药卫生—内科学]