双相门冬胰岛素两种给药方式对糖尿病患者胰岛细胞功能影响的对比研究  

Comparison of Different Injection Methods of Biphasic Insulin Aspart 30 on the Function of Islet Cells of Patients with Type 2 Diabetes

作　　者：王红祥[1] 陈莉[1] 李娜[1] 丁胜[1] 王利[1] 赵湜[1] 

机构地区：[1]湖北省武汉市中心医院内分泌科,430014

出　　处：《中国全科医学》2011年第8期864-866,共3页Chinese General Practice

摘　　要：目的对比分析双相门冬胰岛素(诺和锐30)两种给药方式(三餐前与早晚餐前分别皮下给药)对2型糖尿病患者临床疗效及胰岛细胞功能的影响。方法 96例2型糖尿病患者分为两组:A组(48例,1日3次使用双相门冬胰岛素,三餐前)和B组(48例,1日2次使用双相门冬胰岛素,早晚餐前),治疗12周。治疗前后均测定0、0.5、1.0、2.0 h血糖和血浆胰岛素、C肽浓度,比较两组患者血糖达标的时间、低血糖发生次数、糖化血红蛋白、三酰甘油、总胆固醇水平和胰岛细胞功能。结果 A组糖化血红蛋白和血糖达标时间明显少于B组,差异均有统计学意义(P<0.05);两组胰岛素日用量及低血糖发生次数间差异均无统计学意义(P>0.05)。治疗12周后两组三酰甘油和总胆固醇水平均较治疗前明显下降,且治疗后两组比较差异有统计学意义(P<0.05);治疗后两组空腹及餐后2.0h C肽水平明显升高,A组C肽水平明显高于B组,差异有统计学意义(P<0.05);两组患者胰腺功能均明显改善,表现为胰岛β细胞功能指数和早时相胰岛素分泌指数均升高,且A组明显优于B组,差异有统计学意义(P<0.05)。结论 1日3次使用双相门冬胰岛素是一种更有效改善患者胰岛细胞功能的方法,值得临床推广应用。Objective To assess the efficacy and function of islet cell treated by twice and thrice daily biphasic insulin aspart 30（BIAsp 30） on 96 patients with type 2 diabetes. Methods 96 patients with type 2 diabetes were divided into group A（n=48,thrice daily biphasic insulin aspart 30,before three meals） and group B（n=48,twice daily biphasic insulin aspart 30,before breakfast and dinner）.Both groups were treated for 12 weeks.Plasma glucose,insulin concentration and peptide C at 0,0.5h,10h,20h were tested before and after treatment.Triglyceride,cholesterol,times of hypoglycemia,GHbA1c,HOMA-beta index and early phase insulin secretion index were detected and calculated. Results The GHbA1c level and the time before plasma glucose reached target in group A was significantly less than those of group B（P0.05）.The daily dose of insulin and the times of hypoglycemia between the two groups showed no statistical difference（P0.05）.After 12 weeks treatment,the levels of triglyceride and cholesterol in the two groups were both significantly reduced（P0.05）;The levels of fasting peptide C and after meal peptide C at 20h were significantly increased,and their levels in group A were significantly higher than those in group B（P0.05）.Patients′ pancreatic function were significantly improved in both groups,showing higher HOMA-beta index and early phase insulin secretion index,with group A significantly higher than group B（P0.05）. Conclusion Thrice-daily BIAsp 30 can improve effectively the islet cell function,and it should be recommended to use widely.

关 键 词：双相门冬胰岛素 糖尿病 胰岛细胞 

分 类 号：R587.1[医药卫生—内分泌]