利格列汀联合赖脯胰岛素50对初诊2型糖尿病的临床疗效及安全性分析  

Efficacy and safety of linagliptin combined with insulin lispro50/50 in newly diagnosed type 2 diabetes mellitus patients

作　　者：杨静[1] 徐静[1] 郑宏庭[1] 

机构地区：[1]第三军医大学新桥医院内分泌科,重庆400037

出　　处：《第三军医大学学报》2016年第16期1858-1861,共4页Journal of Third Military Medical University

基　　金：国家自然科学基金青年科学基金(81401601)~~

摘　　要：目的探讨利格列汀联合赖脯胰岛素50治疗初诊2型糖尿病(type 2 diabetes mellitus,T2DM)的疗效与安全性。方法选择2015年1-7月于本科门诊就医,符合纳入及排除标准的131例初诊T2DM患者,最终完成随访的观察组和对照组各61例,包括男性66名,女性56名,年龄(44.6±11.3)岁。观察组采用利格列汀联合赖脯胰岛素50治疗,对照组单用赖脯胰岛素50治疗,比较基线水平和治疗12周后两组空腹血糖、餐后2 h血糖、糖化血红蛋白、体质量指数、胰岛素每日需要量、胰岛素抵抗指数变化、随访期间低血糖发生人次。结果 12周后观察组和对照组的空腹血糖、餐后2 h血糖、糖化血红蛋白分别降至(6.8±0.6)、(6.6±1.0)mmol/L,(8.9±1.2)、(8.5±1.4)mmol/L,(6.9±1.0)%、(6.7±0.8)%,两组均较基线水平下降显著(P<0.05),两组下降幅度差异无统计学意义(P>0.05)。两组患者体质量指数治疗前后差异无统计学意义(P>0.05)。观察组每日胰岛素需要量、胰岛素抵抗指数分别降至(15.1±2.2)U、2.92±0.21,较基线水平显著下降,差异有统计学意义(P<0.05)。随访期间观察组发生低血糖为7人次,对照组为19人次,差异有统计学意义(P<0.05)。结论对于初诊T2DM患者,与单独使用赖脯胰岛素50相比,利格列汀联合赖脯胰岛素50在控制血糖的同时可减少胰岛素使用量,改善胰岛素抵抗,并且更少发生低血糖。Objective To assess the efficacy and safety of linagliptin combined with insulin lispro50 /50 in newly diagnosed type-2 diabetes mellitus（ T2DM） patients. Methods A total of 131 outpatients with newly diagnosed T2 DM from January to July in 2015 was enrolled from Xinqiao hospital. After follow-up,the patients were divided into the observation group and the control group,with 61 patients in each group. There were 66 males and 56 females at an average age of 44. 6 ± 11. 3 years old. The observation group was administered with linagliptin combined with insulin lispro50 /50,while the control group was given with single insulin lispro50 /50 for 12 weeks. The fasting plasma glucose（ FPG）,2-hour postprandial plasma glucose（ 2h PG）,hemoglobin Alc（ Hb Alc）,body mass index（ BMI）,daily insulin dosage,insulin resistance index（ HOMA-IR）,and the incidence of hypoglycemia in the both groups were observed. Results After12 weeks,the levels of FPG,2h PG and Hb Alc were decreased in both groups（ P〈 0. 05）. FPG,2h PG and Hb A1 c of the observation group and the control group were 6. 8 ± 0. 6 and 6. 6 ± 1. 0 mmol / L,8. 9 ± 1. 2 and8. 5 ± 1. 4 mmol / L,and（ 6. 9 ± 1. 0） % and（ 6. 7 ± 0. 8） %,respectively. There were significant decreases in the above indexes,but no statistical differences were observed in the decrease amplitudes between the 2groups（ P〉 0. 05）. There was no significant difference in BMI（ P〉 0. 05）. Daily insulin dosage and HOMA-IR were reduced to 15. 1 ± 2. 2 U and 3. 0 ± 0. 2,respectively,in the observation group,and it showed a significant difference compared with the baseline level（ P〈 0. 05）. During the follow-up,the hypoglycemia incidences in the observation group and the control group were 9 cases and 12 cases,respectively,with statistically significant difference（ P〈 0. 05）. Conclusion Compared with the insulin lispro50 /50 alone,linagliptin combined with insulin lispro50 /50 can significantly decrease the levels of daily insulin dosage and

关 键 词：赖脯胰岛素50 利格列汀 初诊2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌] R969.4[医药卫生—内科学]