甘精胰岛素联合格列美脲治疗老年糖尿病的疗效观察  

Glargine combined with glimepiride for diabetes in elderly patients

作　　者：顾平[1] 陈晓倩[1] 王亚梅[1] 

机构地区：[1]南京市市级机关医院,江苏南京210018

出　　处：《医学研究生学报》2009年第7期742-744,749,共4页Journal of Medical Postgraduates

摘　　要：目的:甘精胰岛素是一种新型长效人胰岛素类似物,格列美脲是具有胰外降血糖作用的降糖药。文中比较甘精胰岛素联合格列美脲治疗老年糖尿病血糖控制情况与发生低血糖的风险。方法:40例应用口服降糖药控制血糖效果不佳的老年糖尿病患者[空腹血糖(FBG)≥10 mmol/L)],按治疗方法分为中效鱼精蛋白锌人胰岛素(NPH)联合格列美脲组19例,甘精胰岛素联合格列美脲治疗组21例。依照空腹血糖(FBG)水平调整胰岛素用量,治疗目标值FBG<7.0 mmol/L,治疗时间12周。观察治疗后空腹及餐后2 h血糖(2 h PBG)水平、低血糖、糖化血红蛋白(HbA1c)及体质量指数(BMI)等指标的变化情况。结果:治疗后2组患者FBG、2 h PBG及HbA1c均明显低于治疗前水平(P<0.05),甘精胰岛素联合格列美脲组低血糖发生率明显低于NPH联合格列美脲(P<0.05),甘精胰岛素联合格列美脲组治疗前后BMI无明显差异(P>0.05),而NPH联合格列美脲组治疗前后BMI有明显差异(P<0.05)。结论:甘精胰岛素联合格列美脲可较好地控制老年糖尿病患者的血糖,低血糖发生率低,对患者体质量影响小,具有安全、方便的特点,是老年糖尿病患者理想的治疗方案。Objective： Insulin glargine is a new long-acting basal insulin analogue. Glimepiride is an anti-diabetic drug with action independent of the pancreas. In this study, the efficacy and safety of glargine plus glimepiride in the treatment of elderly diabetic patients were evaluated. Methods： Sixtyfive elderly diabetic patients were randomly assigned to receive Neutral protamine hagedorn insulin （NPH） plus glimepiride （n = 19）, and glargine plus glimepiride （n =21 ）. The dose of insulin was adjusted according to the fasting blood glucose （FBG） level, with the target FBG 〈 7.0 mmol/L, the treatment lasting 12 weeks. FBG, PBG, the incidence of hypoglycemia, HbAle and the body mess index （BMI） were observed. Results： Blood glucose levels were significantly decreased after treatment in both of the groups as compared with pre-treatment （P 〈 0.05）. The incidence of hypoglycemia in the glargine plus glimepiride group was significantly lower than that in the NPH plus glimipiride group （ P 〈 0.05 ）. There was no significant difference in BMI before and after treatment in the glargine plus glimepiride group. BMI was significantly decreased after treatment in the NPH plus glimipiride group as compared with pre-treatment （P 〈 0.05 ） Conclusion： Glargine plus glimepiride can control the blood glucose level, decrease the incidence of hypoglycemia and minimally affect BMI.

关 键 词：甘精胰岛素 格列美脲 中效鱼精蛋白锌人胰岛素 老年糖尿病 

分 类 号：R587.1[医药卫生—内分泌]