阿卡波糖联合甘精胰岛素治疗2型糖尿病合并甲亢的临床效果  

Clinical Analysis of Acarbose Combined with Insulin Glargine in the Treatment of Type 2 Diabetes Mellitus Complicated with Hyperthyroidism

作　　者：郑羽 ZHENG Yu(Department of Medicine,Guhuai Town Central Health Center of Changle District,Fuzhou 35025,China)

机构地区：[1]福州市长乐区古槐镇中心卫生院内科,福州350205

出　　处：《中国医药指南》2024年第35期77-80,共4页Guide of China Medicine

摘　　要：目的探讨阿卡波糖联合甘精胰岛素治疗2型糖尿病合并甲亢的临床效果。方法选取2018年5月至2023年4月福州市长乐区古槐镇中心卫生院收治的2型糖尿病合并甲状腺功能亢进者80例为研究对象,按照随机数字表法分为观察组及对照组,各40例。对照组使用甲巯咪唑结合甘精胰岛素皮下注射,观察组在对照组用药基础上联合使用阿卡波糖,比较两组血糖控制达标时间及治疗期间日最大血糖波动幅度、分析治疗后两组甲状腺功能、血管内皮功能与脂联素水平变化,统计两组不良反应发生情况。结果观察组空腹血糖和餐后2 h血糖达标耗时短于对照组(P<0.05),日最大血糖波动幅度小于对照组(P<0.05)。治疗后,观察组T_(3)、T_(4)、FT_(3)和FT_(4)水平均低于对照组(P<0.05),TSH高于对照组(P<0.05);观察组发生低血糖、高血糖、心悸、心律失常和高血压的总比例低于对照组(P<0.05)。结论针对2型糖尿病合并甲状腺功能亢进者,甘精胰岛素联合阿卡波糖治疗可快速促进血糖和维持甲状腺功能稳定,提高对血糖内皮功能的保护作用,并减少治疗期间不良反应的发生。Objective To explore the clinical effect of acarbose combined with insulin glargine in the treatment of type 2 diabetes mellitus complicated with hyperthyroidism.Methods A total of 80 patients with type 2 diabetes complicated with hyperthyroidism in Guhuai Town Central Health Center of Changle District from May 2018 to April 2023 in our hospital were randomly divided into two groups,40 cases each.The control group was injected with methimazole combined with insulin glargine subcutaneously,while the observation group was combined with acarbose on basis of control group.The time of reaching the standard of blood glucose control and the maximum daily blood glucose fluctuation range during treatment were compared between the two groups.The changes of thyroid function,vascular endothelial function and adiponectin level in the two groups after treatment were analyzed,and the adverse reactions of the two groups were counted.Results The time for fasting blood glucose and 2-hour postprandial blood glucose to reach the target in the observation group was shorter than that in the control group(P<0.05),and the maximum daily blood glucose fluctuation amplitude was lower than that in the control group(P<0.05).After treatment,the levels of T_(3),T_(4),FT_(3),and FT_(4) in the observation group were lower than those in the control group(P<0.05),while TSH was higher than that in the control group(P<0.05).The total proportion of hypoglycemia,hyperglycemia,palpitations,arrhythmia,and hypertension in the observation group was lower than that in the control group(P<0.05).Conclusions For type 2 diabetes complicated with hyperthyroidism,used methimazole,insulin glargine subcutaneously and acarbose can quickly promote blood sugar,maintain the stability of thyroid function,improve the protection of blood sugar endothelial function,and reduce adverse reactions during treatment.

关 键 词：甲状腺功能亢进 阿卡波糖 2型糖尿病 甘精胰岛素 

分 类 号：R587.1[医药卫生—内分泌] R581.1[医药卫生—内科学]