两种胰岛素强化方案治疗2型糖尿病的疗效比较  

Comparation of Two Different Intensive Insulin Treatment for Type 2 Diabetes Patients

作　　者：薛云[1] 胡继红[1] 成金罗[1] 杨科春[1] 

机构地区：[1]南京医科大学附属常州市第二人民医院内分泌科,江苏常州213003

出　　处：《中国临床医学》2013年第1期40-41,共2页Chinese Journal of Clinical Medicine

摘　　要：目的:比较采用两种胰岛素强化方案治疗2型糖尿病的有效性及安全性。方法:2型糖尿病患者180例,随机分为A、B两组。A组82例,每日三餐前10min皮下注射双时相门冬胰岛素30;B组98例,三餐前10min皮下注射门冬胰岛素注射液,并在睡前皮下注射甘精胰岛素注射液。比较两组治疗前后空腹血糖、餐后2h血糖、每日胰岛素用量、低血糖发生率、随访3个月后两组脱落率及糖化血红蛋白(HbA1C)。结果:A、B组患者的日胰岛素平均用量分别为(38.65±7.77)U、(40.27±11.72)U(P>0.05);A组在治疗期间发生低血糖11例(13.41%),B组发生低血糖10例(10.20%),两组差异无统计学意义(P>0.05);两组治疗后空腹血糖、餐后2h血糖水平均较治疗前显著下降(P<0.01),但组间比较差异无统计学意义;随访3个月后A、B组的HbA1C水平分别为(6.91±0.74)%和(6.91±0.71)%,差异无统计学意义(P>0.05);A组脱落5例(6.10%),B组17例(17.35%),两组脱落率比较差异有统计学意义(P<0.05)。结论:两种强化治疗方案均安全、有效,但每日3次皮下注射双时相门冬胰岛素30的方案更方便,患者的依从性更好。Objective：To compare the efficacy and safety of two intensive insulin treatment（aspart 30 injection before three meals and aspart R injection before three meals combined with one lantus injection）.Methods：A total of 180 type 2 diabetes patients were divided into Group A and Group B.There were 82 patients in Group A and they received subcutaneous injection of aspart 30 before three meals.There were 98 patients in Group B and they received subcutaneous injection of aspart R before three meals combined with lantus at bed time.The levels of fasting plasma glucose（FBG）,2-hour postprandial plasma glucose（2hPBG）before or after the treatment,the daily insulin dose,the incidence of hypoglycemia,glycosylated hemoglobin（HbA1c）after 3 months in the two groups were compared.Results： Both therapies can decrease blood glucose（P0.01）.The insulin dose did not show difference between the two groups（P0.05）.After 3 months,the drop out rate of Group B was higher than that of Group A（P0.05）.HbA1c and the incidence of hypoglycemia had no significant difference between the two groups（P0.05）.Conclusions： Both intensive therapies can control blood glucose effectively and safely,but the therapy of as part 30 injection before three meals is more easy to apply.

关 键 词：2型糖尿病 胰岛素强化治疗 双时相门冬胰岛素30 

分 类 号：R587.1[医药卫生—内分泌]