摘要
目的研究初诊2型糖尿病胰岛素治疗达到临床缓解的影响因素。方法将2009年1月至2012年7月住院初诊为2型糖尿病的96例患者随机分为口服药联合长效胰岛素组28例、速效联合长效胰岛素组20例、预混胰岛素组36例、胰岛素泵强化治疗2周组12例,分别给予相应治疗,以空腹血糖(FPG)<6.1 mmol/L、餐后2小时血糖(2hPG)<8.0 mmol/L出院。出院后坚持原治疗方案治疗3个月,3个月后停止所用治疗并连续监测1个月血糖,每周测3次FPG、2hPG,如1个月内有3次或以上FPG≥7.0 mmol/L或2hPG≥10.0 mmol/L视为治疗失败,否则视为治疗成功。根据治疗结果,分为成功组和失败组。在入院后第2天和3个月随访期结束时空腹测患者身高、体质量,计算体质量指数(BMI),抽血查FPG、糖化血红蛋白(HbA1c)、三酰甘油(TG)、空腹C肽(FCP)、C-反应蛋白(CRP),口服75 g葡萄糖粉后2 h抽血查2hPG,餐后2小时C肽。统计比较不同治疗方案的成功缓解率并分析影响成功的因素。结果治疗后总成功率为73.9%。口服药联合长效胰岛素组成功率为82.1%(23/28);速效联合长效胰岛素组为80.0%(16/20);预混胰岛素组为61.1%(22/36);胰岛素泵强化治疗2周组为83.3%(10/12)。口服药联合长效胰岛素组、速效联合长效胰岛素组、胰岛素泵强化治疗2周组成功率两两比较,差异均无统计学意义(P>0.05);而三组与预混胰岛素组比较,差异有统计学意义(P<0.05)。所有患者FPG、2hPG、HbA1c、TG、CRP较治疗前均明显下降,FCP均明显上升,差异有统计学意义(P<0.05)。成功组与失败组年龄,治疗前BMI、FPG、FCP、TG、CRP比较,差异均有统计学意义[(42.98±4.68)、(56.79±7.65)岁,(25.03±2.46)、(28.16±2.09)kg/m2,(11.89±2.61)、(14.75±2.75)mmol/L,(1.85±0.70)、(0.88±0.54)ng/mL,(1.05±0.68)、(2.41±0.84)mmol/L,(8.19±0.74)、(10.62±1.19)mg/L,P<0.05]。结论初诊2型糖尿病进行胰岛素治疗有较高的临床缓解率。口服药联合长效胰岛�
Objective To study the factors of influencing the newly diagnosed type 2 diabetes mellitus（T2DM） to achieve clinical remission. Methods 96 patients with newly diagnosed T2DM were randomly divided into oral medicine and long-acting insulin group （n=28）, rapid-acting and long-acting insulin group （n=20）, premixed insulin （n=36）, group of insulin pump inten- sive therapy for 2 weeks （n= 12 ）. All the groups were with corresponding treatment, and the patients discharged from hospital when fasting blood glucose （FPG） was less than 6.1 mmol/L and 2 hour postprandial blood glucose （2hPG）was less than 8.0 mmol/L. The o- riginal therapeutic schedule was insisted 3 months after hospital discharge, and the blood glucose was continuously monitored for 1 month after stopped treatment;FPG and 2hPG were determined three times for a week;during the month,the case of FBG 〉17 mmol/L or 2hPG≥ 10 mmol/L marked as failure（F） ,in contrary as success（S）. The 2nd day after admission and after 3 month,the height, weight, body mass index （B MI ）, FPG, glycosylated hemoglobin （HbA 1 c ）, triglyceride （ TG ）, fasting C peptide （FCP）, C re- active protein （CRP）, 2hPG and 2 hour postprandial C peptide （PCP） after 75 g oral glucose powder were measured. To statistically compare the successful remission rate of different therapeutic methods and analyze the influencing factors. Results The total success rate was 73.9% after treatment. The success rate of oral medicine and long-acting insulin group was 82.1% （23/28）;the success rate of rapid-acting insulin and long-acting insulin group was 80.0% （16/20）;the success rate of premixed insulin group was 61.1% （22/36）;the success rate of insulin pump group was 83.3% （lO/12）. Between oral medicine and long-acting insulin group, rapid-acting insulin and long-acting insulin group, insulin pump, there was no statistically significant difference in success rate （P〉O.05）, but they had statistically significant difference c
出处
《现代医药卫生》
2013年第24期3688-3690,共3页
Journal of Modern Medicine & Health
关键词
糖尿病
2型
胰岛素
长效
治疗应用
抽样研究
血糖
分析
年龄因素
C肽
临床缓解
影响因素
Diabetes mellitus,type 2
Insulin,long-acting/therapeutic use
Sampling studies
Blood glucose/analysis
Age factors
C-peptide
Clinical remission
Influence factor
