胰岛素强化治疗2型糖尿病性脂肪肝  

Clinical Observation for Intensive Insulin Therapy in Type 2 Diabetics with Fatty Liver

作　　者：崔京男[1] 姜今华[1] 裴海成[2] 

机构地区：[1]延边第二人民医院内分泌科,吉林延吉133000 [2]延边大学附属医院内分泌科,吉林延吉133000

出　　处：《广州医学院学报》2009年第6期31-33,共3页Academic Journal of Guangzhou Medical College

摘　　要：目的:探讨2型糖尿病性脂肪肝患者控制高血糖的最佳方法。方法:收集本院内分泌科32例2型糖尿病性脂肪肝患者自愿分为甘精胰岛素联合门冬胰岛素治疗组(GA组,n=16)与重组人胰岛素N联合门冬胰岛素治疗组(NA组,n=16),观察每组病人治疗前后各项,临床指标变化。结果:治疗后GA组和NA组空腹血糖(5.25±0.64)mmol/L、6.51±1.23)mmol/L和餐后2 h血糖(7.32±1.05)mmol/L、(9.46±0.52)mmol/L、所需胰岛素剂量(36.8±0.7)IU、(42.8±1.8)IU、血糖波动状况[(1.92±0.87)、(2.95±0.83)mmol/L]、低血糖和黎明现象发生率及血糖达标时间等各项指标相比较,GA组明显低于NA组(P<0.05),同时肝功能改善更明显。结论:胰岛素强化治疗是2型糖尿病性脂肪肝控制血糖的理想治疗方法,但甘精胰岛素联合门冬胰岛素治疗更有优势。Objective：To investigate the optimal treatment of blood sugar control in type 2 diabetics with fatty liver. Methods：32 cases of type 2 diabetics with fatty liver were voluntarily divided into the Glargine and Aspart insulins treated group （group GA, n = 16） and rh-insulin plus aspart insulin treated group （group NA, n = 16）. The changes of clinical measures in each group were observed before and after treatment. Results ： The levels of fasting plasma glucose and 2 hours postprandial glucose, insulin dosage, blood glucose fluctuation in group GA [ （5.25 ± 0. 64） mmol/L, （7.32 ± 1.05 ） mmol/L, （36.8 ± 0.7 ） IU, （ 1.92 ± 0.87 ） mmol/L] were significantly lower than those in group NA [ （6.51 ±1.23） mmol/L, （9.46 ± 0.52） mmol/L, （42.8 ± 1.8） IU, （2.95± 0.83 ） mmol/L, all P 〈 0. 05 ]. Simultaneously,time to blood sugar control, incidence of hypoglycemia and dawn phenomenon in group GA were significantly shorter or lower than those in group NA （ all P 〈 0.05 ）. The liver function of group GA was improved earlier. Conclusion：Intensive insulin therapy might be the perfect choice for type 2 diabetic with fatty liver. Glargine and aspart insulins in combination may be advantageous over treatment with rh-insulin plus insulin aspart.

关 键 词：糖尿病 2型 脂肪肝 胰岛素 高血糖症 低血糖症 

分 类 号：R587.1[医药卫生—内分泌]