CAJ | 학술논문

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.
목적 비교지속피하이도소수주 (CSII) 급연합이갑쌍고혹필격렬동대단병정T2DM주원환자적료효,탐토단병정T2DM강화치료적우화방안.방법 73례적단병정T2DM주원환자수궤분위CSII조(23례)、CSII연합이갑쌍고(CSII+Met)조(26례)、CSII연합필격렬동(CSII+Pio)조(24례).측정강화치료2주전후각조환자FPG、Ins、C-P、hsC-RP급75g포도당부하후2hPG、Ins、C-P.응용은태모형계산β세포공능(HOMA-β) 화이도소저항지수(HOMA-IR),동시비교삼조치료전후각지표적변화급치료비용.결과 강화치료후CSII+Met조、CSII+Pio조여CSII조상비HOMA-β수평현저승고(P＜0.05),HOMA-IR수평현저하강(P＜0.05);CSII+Met조비CSII조、CSII+Pio조혈당체표시간현저축단、이도소용량급치료비용현저하강(P＜0.05).결론 CSII연합이갑쌍고혹연합필격렬동교단순CSII능경유효적개선T2DM환자적이도β세포공능,감경이도소저항;CSII연합이갑쌍고능명현감소이도소용량화치료비용.
Objective To compare the therapeutic effects between continuous subcutaneous insulin infusion (CSII) plus metformin and CSII plus pioglitazone in shortterm T2DM. Methods73 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(hsC-RP) were measured and postprandial glucose(PG),Ins, CP, hsCRP were measured at 2h after taking 75g glucose. Steadystate model βcell function (HOMA-β) 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β levels were increased(P＜0.05), HOMA-IR levels decreased significantly(P＜0.05) 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＜0.05). ConclusionsCompared 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.