胰岛素泵联合二甲双胍在2型糖尿病强化治疗中应用观察被引量：11

Clinical study of continuous subcutaneous insulin infusion combined with metformin hydrochloride in the intensive treating of type 2 diabetes mellitus

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摘要目的观察胰岛素泵联合二甲双胍在2型糖尿病强化治疗中的应用价值及临床疗效。方法240例2型糖尿病患者随机分为胰岛素泵持续皮下注射联合二甲双胍治疗（A组）80例、胰岛素持续皮下注射治疗（B组）80例和多次皮下注射胰岛素治疗（C组）80例，均连续治疗10d。比较三组治疗前后、治疗后3个月血糖、糖化血红蛋白（治疗后4周）、胰岛素用量、C肽水平及胰岛素抵抗指数、胰岛素敏感指数（IAI）。结果A、B两组糖化血红蛋白低于c组[分别为：（6．9±1．4）％、（7．0±1．2）％与（8．0±3．2）％，均P〈0．05]；A、B、C三组患者血糖均能达标，A、B组比C组达标时间短[分别为：（3．0±1．4）d、（3．5±1．5）d与（6．0±1．9）d，均P〈0．05]、胰岛素用量减少[38．0±15．0（U／d）、45．0±16（U／d）与55．0±17．0（U／d），均P〈0．05]，A组比B组胰岛素用量更少（P〈0．05）；A组与B组、C组相比较胰岛素抵抗指数明显降低（分别为：0．8±0．3与1．5±0．4、1．6±0．4，均P〈0．05）、胰岛素敏感指数明显增加（-2．0±4．3与-3．6±4．2、-4．1±4．3，均P〈0．05），且无心、肝、肾功能损害发生。结论胰岛素泵联合二甲双胍用于2型糖尿病的强化治疗更能有效地控制血糖、减少胰岛素用量、减轻胰岛素抵抗。 Objective To evaluate the effect of continuous subcutaneous insulin infusion （CSII）combined with mefformin hydrochloride（ Met H）on type 2 diabetic patients. Methods 240 patients with type 2 diabetes mellitus （T2DM） were divided into 3 groups randomly ： CSII combined with Met H （ A group ： n = 80） ; simple CSII （ B group ： n = 80） ; multiple deliver insulin （MDI）（ C group ： n = 80）. The levels of blood glucose, HbA1 c, therapeutic time, amount of insulin, Fins, C-P, HOMA-IR and IAI were compared among them before and after 10d of treatment. Results GroupA,B compared with group C ,the levels of HbAlc significantly decreased in other two groups[ （ 8.0±3.2） % vs. （6.9± 1.4） % and （7.0± 1.2） % ] （ all P 〈 0. 05 ）, so did the therapeutic time [ （ 6. 0 ± 1.9） d vs. （ 3.0 ±1.4 ） and（ 3.5 ±1.5 ） d ] and insulin dose [ （ 55.0 ± 17.0） U/d vs. （ 38.0± 15.0 ） U/d and （ 45.0 ± 16 ） U/d ] （ all P 〈 0. 05）. The insulin dose was much less in group A than in group B. Versus group B and C,the HOMA-IR of group A （0. 8 ±0. 3 vs. 1.5 ±0.4 and 1.6 ± 0. 4） decreased （ P 〈 0. 05 ）, and IAI （ - 2. 0 ±4. 3 vs. - 3.6 ± 4.2 and - 4. 1 ± 4. 3 ）increased （ all P 〈 0. 05）, without the function impairments of heart, liver or kidney. Conclusion CSII in combination with mefformin hydrochloride can significantly enhance the treatment effect of the patients with type 2 diabetes meUitus;reduce blood glucose and HbAlc,improve insulin resistence,lessen insulin need.

作者郑军邹秀兰

机构地区宜昌市第一人民医院内分泌科

出处《中国基层医药》 CAS 2008年第10期1589-1590,共2页 Chinese Journal of Primary Medicine and Pharmacy

关键词糖尿病 2型胰岛素输注系统胰岛素抗药性二甲双胍 Diabetes mellitus,type2 Insulin infusion systems Insulin resistance Mefformin

分类号 R587 [医药卫生—内分泌]

作者简介通讯作者：邹秀兰，Email：zoux161@126．com

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