胰岛素泵联合磷酸西格列汀治疗初诊2型糖尿病患者的临床效果  

Clinical effect of Insulin pump combined with Sitagliptin Phosphate in the treatment of newly diagnosed type 2 diabetes mellitus patients

作　　者：康庐琛[1] 李文斌[1] 兰浩[1] 刘冰玲 KANG Luchen;LI Wenbin;LAN Hao;LIU Bingling(Department of Endocrine Medicine,the First People′s Hospital of Jiujiang City,Jiangxi Province,Jiujiang332000,China)

机构地区：[1]江西省九江市第一人民医院内分泌内科,江西九江332000

出　　处：《中国当代医药》2021年第36期47-50,共4页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(20204176)。

摘　　要：目的探讨胰岛素泵与磷酸西格列汀联合治疗初诊2型糖尿病(T2DM)患者的临床效果。方法选取2018年1月至2019年12月江西省九江市第一人民医院收治的88例初诊T2DM患者作为研究对象,按照随机数字表法将其分为对照组(44例)和观察组(44例)。对照组患者单用胰岛素泵治疗,观察组患者加用磷酸西格列汀治疗。比较两组患者的血糖、胰岛素抵抗、胰岛素用量、血糖达标时间及不良反应发生状况。结果两组患者治疗前的血糖状况比较,差异无统计学意义(P>0.05);两组患者治疗后的糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)水平低于治疗前,差异有统计学意义(P<0.05);观察组患者治疗后的HbA1c[(6.52±0.57)%]、FPG[(5.68±0.51)mmol/L]、2 h PG[(7.52±1.14)mmol/L]低于对照组[(7.34±0.85)%、(6.75±0.73)mmol/L、(8.69±1.23)mmol/L],差异有统计学意义(P<0.05);两组患者治疗前的胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)比较,差异无统计学意义(P>0.05);两组患者治疗后的HOMA-β高于治疗前,HOMA-IR低于治疗前,差异有统计学意义(P<0.05);观察组患者治疗后的HOMA-β为(65.82±6.14),高于对照组的(59.41±5.73),观察组患者治疗后的HOMA-IR为(2.95±0.63),低于对照组的(3.41±0.85),差异有统计学意义(P<0.05);观察组患者的胰岛素用量[(14.67±4.31)U]少于对照组[(20.15±5.16)U],观察组患者的血糖达标时间[(8.31±1.25)d]短于对照组[(11.84±2.69)d],观察组患者的不良反应总发生率(4.55%)低于对照组(20.45%),差异有统计学意义(P<0.05)。结论胰岛素泵联合磷酸西格列汀治疗初诊T2DM患者,可稳定患者的血糖,改善胰岛素抵抗现象,增强胰岛β细胞功能,安全可靠。Objective To investigate the clinical effect of Insulin pump combined with Sitagliptin Phosphate in the treatment of newly diagnosed type 2 diabetes mellitus patients.Methods A total of 88 newly diagnosed type 2 diabetes mellitus patients who were treated in the First People′s Hospital of Jiujiang City from January 2018 to December 2019 were selected as the study subjects.According to random number table method,they were divided into control group(44 cases)and observation group(44 cases).The control group was treated with Insulin pump alone,and the observation group was treated with Sitagliptin Phosphate based on the control group.The blood glucose,insulin resistance,insulin dosage,time of reaching target of glucose and adverse reactions were compared between the two groups.Results There was no statistically significant difference in the blood glucose between the two groups before treatment(P>0.05).The levels of glycated hemoglobin(HbA1c),fasting plasma glucose(FPG)and 2 hours postprandial blood glucose(2 h PG)in the two groups after treatment were lower than those before treatment,with statistically significant differences(P<0.05).The HbA1c,FPG and 2 h PG in the observation group([6.52±0.57]%,[5.68±0.51]mmol/L,[7.52±1.14]mmol/L]were lower than those in the control group([7.34±0.85]%,[6.75±0.73]mmol/L,[8.69±1.23]mmol/L]after treatment,with statistically significant differences(P<0.05).There were no statistically significant differences in the homeostasis model assessmentβ(HOMA-β)and homeostasis model assessment-insulin resistance(HOMA-IR)between the two groups before treatment(P>0.05).The HOMA-βlevels of the two groups after treatment were higher than those before treatment,and the HOMA-IR levels of the two groups after treatment were lower than those before treatment,with statistically significant differences(P<0.05).After treatment,HOMA-βin the observation group was(65.82±6.14),higher than that in the control group of(59.41±5.73),and HOMA-IR in the observation group was(2.95±0.63),lower than that

关 键 词：2型糖尿病 胰岛素泵 磷酸西格列汀 胰岛素抵抗 胰岛素 

分 类 号：R587.1[医药卫生—内分泌]