胰岛素联合沙格列汀和二甲双胍治疗2型糖尿病并发肺炎的临床疗效  

Clinical effect of insulin combined with saxagliptin and metformin in the treatment of type 2 diabetes complicated with pneumonia

作　　者：李剑珠 LI Jianzhu(Affiliated Hospital of Putian University,Putian 351100,China)

机构地区：[1]莆田学院附属医院,福建省莆田市351100

出　　处：《临床合理用药杂志》2023年第9期23-26,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的 观察胰岛素联合沙格列汀、二甲双胍治疗2型糖尿病并发肺炎的临床疗效。方法 将莆田学院附属医院2020年1月—2022年1月收治的92例2型糖尿病并发肺炎患者按随机数字表法分为对照组和观察组,每组46例。对照组服用沙格列汀、二甲双胍,观察组在对照组基础上给予胰岛素泵注,2组患者均治疗2周。比较2组实验室指标[空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、脑钠肽(BNP)、C反应蛋白(CRP)、降钙素原(PCT)、白介素-6(IL-6)、丙二醛(MDA)、一氧化氮(NO)、超氧化物歧化酶(SOD)、胰岛素抵抗指数(HOMA-IR)]、血糖达标时间、肺炎控制时间及低血糖发生率、重症转化率。结果 治疗2周后,2组FPG、2 hPG、HbA1c及血清BNP、CRP、PCT、IL-6及MDA水平低于治疗前,血清NO、SOD水平高于治疗前,且观察组FPG、2 hPG、HbA1c及血清BNP、CRP、PCT、IL-6及MDA水平低于对照组,血清NO、SOD水平高于对照组(P<0.01)。观察组治疗后HOMA-IR低于对照组,血糖达标时间、肺炎控制时间均短于对照组(P<0.01)。2组低血糖发生率比较,差异无统计学意义(P>0.05),但观察组重症转化率低于对照组(P<0.05)。结论 胰岛素联合沙格列汀、二甲双胍治疗2型糖尿病并发肺炎不仅能够提高血糖控制效果,降低胰岛素抵抗,还可有效降低血清炎性因子水平,减轻氧化应激反应,缩短肺炎控制时间,降低重症转化率,且不会增加低血糖发生风险。Objective To investigate the effect of insulin combined with saxagliptin and metformin in the treatment of type 2 diabetes complicated with pneumonia.Methods A total of 92 patients with type 2 diabetes complicated with pneumonia were selected from January 2020 to January 2022 in Affiliated Hospital of Putian University,and they were divided into the control group and the observation group according to random number table method,46 cases in each group.Patients in the control group were treated with saxagliptin and metformin,and patients in the observation group were given insulin on the basis of the control group.Both groups were treated for 2 weeks.Laboratory indexes(FPG,2 hPG,HbA 1c,BNP,CRP,PCT,IL-6,MDA,NO,SOD,HOMA-IR),blood sugar reaching standard time,pneumonia control time,incidence of hypoglycemia,critical conversion rate were compared between the two groups.Results After 2 weeks of treatment,FPG,2 hPG,HbA 1c and serum levels of BNP,CRP,PCT,IL-6,MDA of the two groups were lower than those before treatment,serum levels of NO,SOD were higher than those before treatment,and FPG,2 hPG,HbA 1c and serum levels of BNP,CRP,PCT,IL-6,MDA of the observation group were lower than those of the control group,serum levels of NO,SOD were higher than those of the control group(P<0.01).HOMA-IR after treatment of the observation group was lower than that of the control group,blood sugar reaching standard time,pneumonia control time were shorter than those of the control group(P<0.01).There was no significant difference of incidence of hypoglycemia between the two groups(P>0.05),but critical conversion rate of the observation group was lower than that of the control group(P<0.05).Conclusion Insulin combined with saxagliptin and metformin can not only improve blood sugar control and reduce insulin resistance in the treatment of type 2 diabetes complicated with pneumonia,but also effectively reduce serum inflammatory factors levels and reduce oxidative stress,shorten the pneumonia control time,reduce the critical conversion rate,

关 键 词：2型糖尿病 肺炎 胰岛素 沙格列汀 二甲双胍 胰岛素抵抗 氧化应激 脑钠肽 炎性因子 

分 类 号：R587.2[医药卫生—内分泌] R563.1[医药卫生—内科学]