钠⁃葡萄糖协同转运蛋白⁃2抑制剂联合胰岛素泵对T2DM患者HOMA⁃IR、ET及FMD水平的影响  

Effects of sodium⁃glucose cotransporter⁃2 inhibitor combined with insulin pump on HOMA⁃IR,ET and FMD levels in patients with T2DM

作　　者：郝士丹 许颖[2] 郝士玉 张景义[2] HAO Shidan;XU Ying;HAO Shiyu;ZHANG Jingyi(Department of Endocrinology,Tangshan Hongci Hospital,Tangshan,Hebei,China,063000;Department of Endocrinology,Kailuan General Hospital,Tangshan,Hebei,China,063000;Department of Cardiology,Tangshan Hongci Hospital,Tangshan,Hebei,China,063000)

机构地区：[1]唐山弘慈医院内分泌科,河北唐山063000 [2]开滦总医院内分泌科,河北唐山063000 [3]唐山弘慈医院心内科,河北唐山063000

出　　处：《分子诊断与治疗杂志》2022年第12期2211-2214,2218,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河北省卫生健康委医学科学研究课题计划项目(20210902)。

摘　　要：目的分析钠⁃葡萄糖协同转运蛋白⁃2抑制剂(SGLT⁃2)联合胰岛素泵对2型糖尿病(T2DM)患者稳态模拟胰岛素抵抗指数(HOMA⁃IR)、内皮素(ET)及内皮舒张功能(FMD)水平的影响。方法选取唐山弘慈医院2019年8月至2021年月8月收治的T2DM患者93例,按照治疗方案不同(遵医嘱)分为对照组(胰岛素泵)45例和观察组(SGLT⁃2抑制剂+胰岛素泵)48例。对比两组治疗前后空腹血糖(FBG)、餐后2小时血糖(2hPG)、糖化血红蛋白(HbA1c)、空腹胰岛素(FIns)、HOMA⁃IR、胰岛β细胞功能指数(HOMA⁃β)、ET、FMD水平及不良反应。结果两组治疗后HbA1c、FBG、2hPBC水平均下降,且观察组治疗后HbA1c、FBG、2hPBC水平均显著低于对照组,差异有统计学意义(P<0.05)。观察组治疗后FIns、HOMA⁃IR水平低于对照组,HOMA⁃β水平高于对照组,差异有统计学意义(P<0.05)。观察组治疗后ET水平低于对照组,FMD水平显著高于对照组,差异有统计学意义(P<0.05)。对照组不良反应发生率13.32%,观察组不良反应发生率4.16%,两组不良反应比较差异无统计学意义(P>0.05)。结论T2DM患者应用SGLT⁃2抑制剂联合胰岛素泵治疗可有效控制血糖水平,进一步改善HOMA⁃IR、ET及FMD水平。Objective To analyze the effects of sodium⁃glucose cotransporter⁃2 inhibitor(SGLT⁃2)combined with insulin pump on steady state simulated insulin resistance index(HOMA⁃IR),endothelin(ET)and endothelial diastolic function(FMD)levels in patients with type 2 diabetes(T2DM)mellitus.Methods 93 patients with T2DM admitted to Tangshan Hongci hospital from August 2019 to August 2021 were selected and divided into the control group(insulin pump)45 cases and the observation group(SGLT⁃2 inhibitor+insulin pump)48 cases according to different treatment schemes(according to medical advice).Fasting blood glucose(FBG),blood glucose 2 hours after meal(2hPG),glycosylated hemoglobin(HbA1c),fasting insulin(FIns),HOMA⁃IR,Islet of LangerhansβCell function index(HOMA⁃β),ET,FMD levels and adverse reactions before and after treatment were compared between the two groups.Results The levels of HbA1c,FBG and 2hPBC in the two groups decreased after treatment,and the levels of HbA1c,FBG and 2hPBC in the observation group were significantly lower than those in the control group after treatment(P<0.05).After treatment,the levels of FIns and HOMA⁃IR in the observation group were lower than those in the control group,and the level of HOMA⁃βwas higher than that in the control group(P<0.05).After treatment,the level of ET in the observation group was lower than that in the control group,and the level of FMD was significantly higher than that in the control group(P<0.05).The incidence of adverse reactions was 13.32%in the control group and 4.16%in the observation group(P>0.05).Conclusion SGLT⁃2 inhibitor combined with insulin pump therapy can effectively control blood glucose level in T2DM patients,and further improve the levels of HOMA⁃IR,ET and FMD.

关 键 词：钠⁃葡萄糖协同转运蛋白⁃2抑制剂 胰岛素泵 2型糖尿病 HOMA⁃IR ET FMD 

分 类 号：R587.1[医药卫生—内分泌]