不同胰岛素治疗磺脲类药物继发性失效的老年糖尿病患者的疗效及对胰岛功能的影响  

Curative effect of different insulin in the treatment of elderly diabetes with secondary sulfonylurea to failure and its impact on pancreas islet function

作　　者：郑锦顺 李杰荣 ZHENG Jin-shun;LI Jie-rong(Department One of Internal Medicine, Dongguan City Hospital of Traditional Chinese Medicine, Dongguan 523000, China)

机构地区：[1]东莞市中医院内一科,523000 [2]东莞市东坑镇社区卫生服务中心

出　　处：《中国现代药物应用》2017年第9期67-69,共3页Chinese Journal of Modern Drug Application

摘　　要：目的探讨不同胰岛素治疗磺脲类药物继发性失效的老年糖尿病患者的疗效及对胰岛功能的影响。方法 66例磺脲类药物继发性失效的老年糖尿病患者作为研究对象,所有患者均停用原口服降糖药,改用格列吡嗪,并同时睡前皮下注射甘精胰岛素(IG)或中性鱼精蛋白锌胰岛素(NPH),分别设为IG组和NPH组,各33例。治疗4个月后采用免疫比浊抑制分析法检测空腹血糖(FPG)、餐后2 h血糖(2 h PG),采用化学发光法检测空腹C肽(FCP)、餐后2 h C肽(2 h CP),记录低血糖事件发生情况。结果治疗后,两组患者的FPG、2 h PG均较本组治疗前明显下降,差异均具有统计学意义(P<0.05);组间治疗后FPG、2 h PG比较,差异均无统计学意义(P>0.05)。IG组治疗后FCP、2 h CP明显高于本组治疗前和NPH组治疗后,差异均具有统计学意义(P<0.05);NPH组治疗前后FCP、2 h CP比较,差异均无统计学意义(P>0.05)。IG组的低血糖发生率为6.06%明显低于NPH组的27.27%,差异具有统计学意义(χ~2=5.345,P<0.05)。结论 IG或NPH治疗磺脲类药物继发性失效的老年糖尿病患者均可有效控制血糖,但IG还能改善胰岛功能,且降低低血糖发生率。Objective To explore the impact of different insulin in the treatment of elderly diabeteswith secondary sulfonylurea to failure and its impact on pancreas islet function.Methods A total of66elderlydiabetic patients with secondary sulfonylurea to failure as study subjects all changed original oral medications toglipizide,and they all received subcutaneous injection of insulin glargine(IG)or neutral protamine Hagendorn(NPH)insulin at bedtime respectively as IG group and NPH group,with33cases in each group.After4monthsof treatment,detection was made on fasting blood-glucose(FPG),2h postprandial blood glucose(2h PG)byimmune turbidimetric inhibition method and fasting C-peptide(FCP)and postprandial2h C-peptide(2h CP)bychemiluminescent immunoassay,and hypoglycemic events occurrence was recorded.Results After treatment,both groups had obviously decreased FPG and2hPG than those before treatment,and the difference had statisticalsignificance(P<0.05).After treatment,both groups had no statistically significant difference in FPG and2h PG(P>0.05).IG group had obviously higher FCP and2h CP than those before treatment and NPH group after treatment,andtheir difference had statistical significance(P<0.05).NPH group had no statistically significant difference in FCPand2h CP before and after treatment(P>0.05).IG group had obviously lower incidence of hypoglycemia as6.06%than27.27%in NPH group,and the difference had statistical significance(χ2=5.345,P<0.05).Conclusion IGor NPH both can effectively control blood glucose of elderly diabetic patients with secondary sulfonylurea to failure,and IG also can improve pancreas islet function and reduce incidence of hypoglycemia.

关 键 词：糖尿病 磺脲类 继发性失效 甘精胰岛素 中性鱼精蛋白锌胰岛素 胰岛功能 

分 类 号：R587.1[医药卫生—内分泌]