餐前大剂量谷赖胰岛素治疗老年2型糖尿病疗效影响因素分析  

Influencing Factors of the Efficacy of High-Dose Insulin Glutamine Before Meal in the Treatment of Elderly Patients with Type 2 Diabetes Mellitus

作　　者：田丰秋[1] 谢万均[1] 任丽媛[1] 于鑫淼[1] 王丹[1] 刘丹阳[1] 徐子奇 杨兰[1] 杨雪梅 苗冬梅 孙红瑛 TIAN Fengqiu;XIE Wanjun;REN Liyuan;YU Xinmiao;WANG Dan;LIU Danyang;XU Ziqi;YANG Lan;YANG Xuemei;MIAO Dongmei;SUN Hongying(Department of Endocrinology,Dalian Friendship Hospital,Dalian,Liaoning,China 116001)

机构地区：[1]辽宁省大连市友谊医院内分泌科,辽宁大连116001

出　　处：《中国药业》2022年第4期90-93,共4页China Pharmaceuticals

基　　金：辽宁省大连市医学科学研究计划项目[1811030]。

摘　　要：目的探讨餐前大剂量谷赖胰岛素治疗老年2型糖尿病(T2DM)疗效的影响因素。方法选取医院2019年1月至2020年1月收治的拟接受餐前大剂量谷赖胰岛素方案治疗的老年T2DM患者175例,均连续治疗3个月后按糖化血红蛋白水平分为有效组和无效组。比较两组患者的一般资料、实验室指标和血压。通过单因素与多因素分析探讨治疗无效的影响因素。结果175例老年T2DM患者中,无效41例(23.43%);两组患者肥胖、病程、胰岛素抵抗指数、脂联素、内脂素及白细胞介素18(IL-18)水平有显著差异(χ^(2)=28.061,U=7.870,6.615,6.980,2.313,2.549,P<0.05);Logistic回归分析结果显示,肥胖、病程长、胰岛素抵抗指数异常、脂联素低表达、内脂素及IL-18过表达均是老年T2DM患者经餐前大剂量谷赖胰岛素方案治疗无效的影响因素(OR=7.788,1.443,5.009,1.542,1.869,1.941,P<0.01)。结论老年T2DM患者经餐前大剂量谷赖胰岛素方案治疗无效,可能受患者肥胖、病程、胰岛素抵抗指数异常等因素影响,临床应重视相应风险的评估,并有针对地实施合理干预。Objective To investigate the factors influencing the efficacy of high-dose insulin glutamine before meals in the treatment of elderly patients with type 2 diabetes mellitus(T2DM).Methods A total of 175 elderly patients with T2DM who were treated with high-dose insulin glutamine before meals from January 2019 to January 2020 were selected.After three months of continuous treatment,they were divided into the effective group and the ineffective group according to the levels of glycosylated hemoglobin.The general data,laboratory indexes and blood pressure of patients in the two groups were compared.The influencing factors of ineffective treatment were investigated by the univariate and multivariate analysis.Results Among 175 elderly patients with T2DM,41 cases(23.43%)were ineffective.There were significant differences in the obesity,course of disease,insulin resistance index,the levels of adiponectin,visfatin and interleukin-18(IL-18)between the two groups(χ^(2)=28.061,U=7.870,6.615,6.980,2.313,2.549,P<0.05).Logistic regression analysis showed that obesity,long course of disease,abnormal insulin resistance index,low expression of adiponectin,overexpression of visfatin and IL-18 were the factors influencing the ineffectiveness of high-dose insulin glutamine before meals in the treatment of elderly patients with T2DM(OR=7.788,1.443,5.009,1.542,1.869,1.941,P<0.01).Conclusion The ineffectiveness of high-dose insulin glutamine before meals in the treatment of elderly patients with T2DM may be affected by obesity,course of disease,abnormal insulin resistance index and other factors.Clinical attention should be paid to the assessment of related risks,and targeted and reasonable intervention should be implemented.

关 键 词：2型糖尿病 老年 谷赖胰岛素 肥胖 病程 胰岛素抵抗指数 脂联素 内脂素 白细胞介素18 

分 类 号：R969.4[医药卫生—药理学] R977.15[医药卫生—药学]