沙格列汀联合不同胰岛素起始治疗方案在2型糖尿病患者中的应用研究  

Research on Application of Saxagliptin Combined with Different Initial Insulin Treatment Regimens in Patients with Type 2 Diabetes Mellitus

作　　者：吴玲玲[1] 孙慧[1] WU Lingling;SUN Hui(Ward One,Geriatric Medical Center,Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010000,China)

机构地区：[1]内蒙古医科大学附属医院老年医学中心一病区,呼和浩特010000

出　　处：《医学综述》2021年第13期2700-2704,共5页Medical Recapitulate

摘　　要：目的观察沙格列汀联合不同胰岛素起始治疗方案在2型糖尿病(T2DM)患者中应用的获益情况。方法选择2018年1月至2019年12月在内蒙古医科大学附属医院确诊并接受治疗的91例T2DM患者为研究对象,依据随机数字法分为观察组(46例)和对照组(45例)。患者均使用沙格列汀治疗,在此基础上,观察组联合预混胰岛素(门冬胰岛素30)治疗;对照组联合基础胰岛素(甘精胰岛素)治疗,两均治疗12周。比较两组患者治疗前、治疗12周的血糖水平[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA 1c)]、胰岛β细胞功能[稳态模型评估的胰岛β细胞功能指数(HOMA-β)、空腹C肽(C-P)],比较两组T2DM控制目标达标率[HbA 1c达标率、血脂达标率、体质指数(BMI)达标率],记录治疗期间不良反应发生情况。结果FPG、2 h PG、HbA 1c的组间和时点间存在交互作用(P<0.01),治疗12周,两组FPG、2 h PG、HbA 1c水平均低于治疗前,且观察组低于对照组(P<0.05)。HOMA-β、空腹C-P的组间和时点间存在交互作用(P<0.01),两组HOMA-β、空腹C-P均高于治疗前,且观察组高于对照组(P<0.05)。两组HbA 1c、血脂、BMI达标率及总不良反应发生率比差异无统计学意义(P>0.05)。结论与基础胰岛素方案比,沙格列汀联合预混胰岛素起始治疗方案更利于改善T2DM患者血糖水平、提高胰岛β细胞功能。Objective To observe the benefit of patients with type 2 diabetes mellitus(T2DM)treated by saxagliptin combined with different initial insulin treatment regimens.Methods A total of 91 patients with T2DM diagnosed and treated in Affiliated Hospital of Inner Mongolia Medical University from Jan.2018 to Dec.2019 were included,and they were divided into an observation group(46 cases)and a control group(45 cases)by the random number method.All the patients were treated with saxagliptin,on this basis,the observation group was combined with premixed insulin(insulin aspart 30);the control group was combined with basal insulin(insulin glargine)for treatment,and both groups were treated for 12 weeks.The blood glucose levels[fast plasma glucose(FPG),2 h postprandial glucose(2 h PG),glycosylated hemoglobin(HbA lc)],isletβ-cell function[homeostasis model assessment isletβ-cell function index(HOMA-β),fasting C-peptide(C-P)]of the two groups before and at 12 weeks of treatment were compared;the T2DM control target reaching rates[HbAlc,blood lipid,body mass index(BMI)]of the two groups were compared;the occurrence of adverse reactions during the treatment was recorded.Results There were interactions in FPG,2 h PG and HbA 1c between groups and time points(P<0.01),after 12 weeks of treatment,the levels of FPG,2 h PG and HbA 1c in both groups were decreased compared with those before treatment,the observation group lower than the control group(P<0.05).There were interactions in HOMA-βand fasting C-P between groups and time points(P<0.01),HOMA-βand fasting C-P in both groups were increased compared with those before treatment,the observation group higher than the control group(P<0.05).There was no significant difference in HbA 1c,blood lipid,BMI target reaching rate and the incidence of total adverse reactions between the two groups(P>0.05).Conclusion Compared with the basal insulin regimen,the initial treatment method of saxagliptin and premixed insulin is more beneficial to improve the blood glucose level and isletβcell func

关 键 词：2型糖尿病 沙格列汀 甘精胰岛素 门冬胰岛素30 血糖 胰岛Β细胞功能 不良反应 

分 类 号：R587.1[医药卫生—内分泌]