摘要
目的比较持续皮下胰岛素输注(CSII)及联合二甲双胍或吡格列酮对短病程T2DM住院患者的疗效,探讨短病程T2DM强化治疗的优化方案。方法 73例的短病程T2DM住院患者随机分为CSII组(23例)、CSII联合二甲双胍(CSII+Met)组(26例)、CSII联合吡格列酮(CSII+Pio)组(24例)。测定强化治疗2周前后各组患者FPG、Ins、C-P、hsC-RP及75g葡萄糖负荷后2hPG、Ins、C-P。应用稳态模型计算β细胞功能(HOMA-β)和胰岛素抵抗指数(HOMA-IR),同时比较三组治疗前后各指标的变化及治疗费用。结果强化治疗后CSII+Met组、CSII+Pio组与CSII组相比HOMA-β水平显著升高(P<0.05),HOMA-IR水平显著下降(P<0.05);CSII+Met组比CSII组、CSII+Pio组血糖达标时间显著缩短、胰岛素用量及治疗费用显著下降(P<0.05)。结论 CSII联合二甲双胍或联合吡格列酮较单纯CSII能更有效的改善T2DM患者的胰岛β细胞功能,减轻胰岛素抵抗;CSII联合二甲双胍能明显减少胰岛素用量和治疗费用。
Objective To compare the therapeutic effects between continuous subcutaneous insulin infusion （CSII） plus metformin and CSII plus pioglitazone in short-term T2DM. Methods 73 hospitalized patients with short-term T2DM were randomly divided into three groups： simple CSII group, CSII plus metformin group, CSII plus pioglitazone group. All cases were treated for 2 weeks, then, fasting plasma glucose（FPG）, insulin（Ins）, C-peptide（C-P） and high sensitivity CRP（hs-CRP） were measured and post-prandial glucose（PG）,Ins, CP, hs-CRP were measured at 2h after taking 75g glucose. Steady- state model t-cell function （HOMA-[3） and insulin resistance index （HOMA-IR）were calculated. The treatment costs and changes of above indicators before and after therapy were compared among three groups. Results HOMA-[3 levels were increased（P^0. 05）, HOMA-IR levels decreased significantly（P d0. 05） in metformin and pioglitazone groups compared with simple CSII group. The glucose target time and treatment costs were reduced, and insulin dosage decreased significantly in metformin group compared with the simple CSII and pioglitazone groups（P〈O. 05）. Conclusions Compared with simple CSII,CSII plus metformin or pioglitazone could improve the function of pancreatin β-cell and reduce IR. CSII plus with metformin versus pioglitazone could decrease insulin dosage and treatment costs and shorten hospitalization period.
出处
《中国糖尿病杂志》
CAS
CSCD
北大核心
2010年第4期281-283,共3页
Chinese Journal of Diabetes
基金
"十五"国家科技攻关计划课题(2001BA702B01)
辽宁省科技厅科技攻关项目(2002225003-6)
辽宁省教育厅高等学校科学研究项目(202203266)
