动态血糖监测评估地特胰岛素的疗效及心血管系统的影响  

Effect of insulin detemir and cardiovascular dynamic blood sugar monitoring and evaluation

作　　者：王筱菁[1] 林健才[1] 朱翠颜[1] 

机构地区：[1]江门市中心医院内分泌科,广东江门529000

出　　处：《临床和实验医学杂志》2015年第11期940-943,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨利用动态血糖监测评估地特胰岛素的疗效及对心血管系统的影响。方法收集2型糖尿病患者共60例,按照治疗用药将患者分为A组、B组和C组,分别采用地特胰岛素、甘精胰岛素和中效胰岛素治疗。利用动态血糖监测系统CGMS评价患者血糖控制的有效性、安全性、对体重的影响及对患者心血管系统的影响。结果 60例2型糖尿病患者采取不同的治疗后,A、B组的糖化血红蛋白(Hb A1c)、空腹血糖(FBG)、餐后2 h血糖(PBG)水平均明显低于C组,差异具有统计学意义(P<0.05);A组和B组以上指标差异无统计学意义(P>0.05)。三组间体质指数(BMI)和胰岛素用量比较差异无统计学意义,两两组间比较A组BMI稍低于B组和C组,A组和B组胰岛素用量稍低于C组,但差异均无统计学意义(P>0.05);三组间A组、B组血糖达标时间均明显低于C组,低血糖发生率也低于C组,差异具有统计学意义(P<0.05),但A组与B组比较差异无显著性;血糖波动和血脂波动方面,A组、B组较C组好,差异具有统计学意义(P<0.05)。随访期间发现:A组心血管事件发生率为30.0%(6/20),B组心血管事件发生率为40.0%(8/20),C组心血管事件发生率为65.0%(13/20)。A组和B组较C组心血管事件发生率低,差异有显著性(P<0.05)。结论利用动态血糖监测发现地特胰岛素疗效较中效胰岛素治疗效果较好,在控制血糖、血脂方面较中效胰岛素有较大的优势,还能降低心血管发生率;而甘精胰岛素与地特胰岛素效果相当。Objective To investigate the use of dynamic blood glucose testing to assess the efficacy of insulin detemir and its effects on the cardiovascular and weight negative. Methods Our hospital nearly 4 years with type 2 diabetes patients with a total 60 cases,the use of systematic reviews glucose monitor blood glucose control efficacy,safety and impact on body weight and the correlation with cardiovascular events. Results 60 patients with type 2 diabetes take a different treatment. The glycated hemoglobin（HbA1C）,fasting blood glucose（FBG）,2 h postprandial blood glucose（PBG）of A and B group were significantly lower than group C. The difference was statistically significant（ P 〈0. 05）. The differ-ence of A group and B group above index was not statistically significant（ P 〉0. 05）. Body mass index among the three groups（BMI）and insulin dosage difference was not statistically significant. The time blood glucose of A and B group were significantly lower than group C. The incidence of hypoglycemia of group A and B also lower than group C,the difference was statistically significant（ P 〈0. 05）. But the difference of the A group and B group was not statistically significant. The fluctuations in terms of fluctuations in blood sugar and lipids of A and B group were better than the group C,the difference was statistically significant（ P 〈0. 05）. The cardiovascular event of A group occurred during follow-up,30. 0%（6/20）,the occurrence rate of cardiovascular event group B was 40. 0%（8/20）,the occurrence rate of cardiovascular group C was 65. 0%（13/20）. The occurrence of cardiovascular event of Group A and Group B is lower than those in group C,the difference was significant（ P 〈0. 05）. Con-clusion The use of continuous glucose monitoring showed detemir had better effect than the effect of insulin treatment in the control of blood glu-cose,and hypertension compared with intermediate-acting insulin have a greater advantage. This method can also reduce the incidence of cardio-

关 键 词：地特胰岛素 动态血糖检测 临床疗效 心血管事件 

分 类 号：R587.1[医药卫生—内分泌]