中国医药
中國醫藥
중국의약
CHINA MEDICINE
2012年
6期
713-715
,共3页
孙胜花%宋钦华%谭丽玲%李大伟
孫勝花%宋欽華%譚麗玲%李大偉
손성화%송흠화%담려령%리대위
糖尿病,自身免疫性%吡格列酮%胰岛素%胰岛素抵抗
糖尿病,自身免疫性%吡格列酮%胰島素%胰島素牴抗
당뇨병,자신면역성%필격렬동%이도소%이도소저항
Diabetes,autoimmune%Pioglitazone%Insulin%Insulin resistance
目的 观察吡格列酮联合胰岛素治疗成人隐匿性自身免疫性糖尿病( LADA)的疗效.方法 将36例新诊断LADA患者完全随机分为单用胰岛素治疗组(17例)和吡格列酮联合胰岛素治疗组(19例).观察12个月,记录比较2组患者治疗后空腹血糖(FPG)、餐后2h血糖(2 hPG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(Homa-IRI)和体重的变化,以及胰岛素用量和低血糖发生情况.结果 治疗12个月后,与治疗前比较,吡格列酮联合胰岛素治疗组和单用胰岛素治疗组患者FPG、2 hPG、HbA1c均得到良好控制[前者分别为(6.4±1.2) mmol/L比(9.1±1.1) mmol/L,(8.7±2.2)mmol/L比(19.2±2.4) mmol/L,(5.8±1.1)％比(8.4±1.3)％,后者分别为(6.9±1.2) mmol/L比(8.4±1.2) mmol/L,(9.0±1.6)mmol/L比(18.1±2.6)mmol/L,(7.2±1.2)％比(8.2±1.4)％,均P＜0.05].治疗后吡格列酮联合胰岛素组HbAlc、Homa-IRI、胰岛素用量、低血糖发生次数均低于单用胰岛素组[(5.8±1.1)％比(7.2±1.1)％,1.16±0.25比1.45±0.28,(17±4) U/d比(27±8)U/d,(0.8±0.3)次/例比(1.6±0.8)次/例,均P＜0.05].结论 吡格列酮联合胰岛素治疗早期LADA患者可更有效控制血糖,减少胰岛素用量及低血糖发生,改善胰岛素抵抗.
目的 觀察吡格列酮聯閤胰島素治療成人隱匿性自身免疫性糖尿病( LADA)的療效.方法 將36例新診斷LADA患者完全隨機分為單用胰島素治療組(17例)和吡格列酮聯閤胰島素治療組(19例).觀察12箇月,記錄比較2組患者治療後空腹血糖(FPG)、餐後2h血糖(2 hPG)、糖化血紅蛋白(HbA1c)、胰島素牴抗指數(Homa-IRI)和體重的變化,以及胰島素用量和低血糖髮生情況.結果 治療12箇月後,與治療前比較,吡格列酮聯閤胰島素治療組和單用胰島素治療組患者FPG、2 hPG、HbA1c均得到良好控製[前者分彆為(6.4±1.2) mmol/L比(9.1±1.1) mmol/L,(8.7±2.2)mmol/L比(19.2±2.4) mmol/L,(5.8±1.1)％比(8.4±1.3)％,後者分彆為(6.9±1.2) mmol/L比(8.4±1.2) mmol/L,(9.0±1.6)mmol/L比(18.1±2.6)mmol/L,(7.2±1.2)％比(8.2±1.4)％,均P＜0.05].治療後吡格列酮聯閤胰島素組HbAlc、Homa-IRI、胰島素用量、低血糖髮生次數均低于單用胰島素組[(5.8±1.1)％比(7.2±1.1)％,1.16±0.25比1.45±0.28,(17±4) U/d比(27±8)U/d,(0.8±0.3)次/例比(1.6±0.8)次/例,均P＜0.05].結論 吡格列酮聯閤胰島素治療早期LADA患者可更有效控製血糖,減少胰島素用量及低血糖髮生,改善胰島素牴抗.
목적 관찰필격렬동연합이도소치료성인은닉성자신면역성당뇨병( LADA)적료효.방법 장36례신진단LADA환자완전수궤분위단용이도소치료조(17례)화필격렬동연합이도소치료조(19례).관찰12개월,기록비교2조환자치료후공복혈당(FPG)、찬후2h혈당(2 hPG)、당화혈홍단백(HbA1c)、이도소저항지수(Homa-IRI)화체중적변화,이급이도소용량화저혈당발생정황.결과 치료12개월후,여치료전비교,필격렬동연합이도소치료조화단용이도소치료조환자FPG、2 hPG、HbA1c균득도량호공제[전자분별위(6.4±1.2) mmol/L비(9.1±1.1) mmol/L,(8.7±2.2)mmol/L비(19.2±2.4) mmol/L,(5.8±1.1)％비(8.4±1.3)％,후자분별위(6.9±1.2) mmol/L비(8.4±1.2) mmol/L,(9.0±1.6)mmol/L비(18.1±2.6)mmol/L,(7.2±1.2)％비(8.2±1.4)％,균P＜0.05].치료후필격렬동연합이도소조HbAlc、Homa-IRI、이도소용량、저혈당발생차수균저우단용이도소조[(5.8±1.1)％비(7.2±1.1)％,1.16±0.25비1.45±0.28,(17±4) U/d비(27±8)U/d,(0.8±0.3)차/례비(1.6±0.8)차/례,균P＜0.05].결론 필격렬동연합이도소치료조기LADA환자가경유효공제혈당,감소이도소용량급저혈당발생,개선이도소저항.
Objective To observe the therapeutic effects of pioglitazone combined with insulin on patients with newly diagnosed latent autoimmune diabetes in adult(LADA).Methods All 36 LADA patients were randomly divided into insulin group ( 17 cases) and pioglitazone plus insulin group ( 19 cases).Seventeen patients in insulin group were treated with insulin and 19 patients in pioglitazone plus insulin group were treated with insulin and pioglitazone during twelve months.The changes of fasting plasma glucose (FPG),2-hour plasma glucose (2hPG),glycolated hemoglobin (HbA1c),insulin resistance index (Homa-IRI),body weight,insulin dosage and hypoglycemia events in different groups were compared after treatment for twelve months.Results Compared to pre-treatment,the levels of FPG,2 hPG,and HbA1 c in pioglitazone plus insulin group [ ( 6.4 ± 1.2 ) mmol/L vs (9.1 ± 1.1 )mmol/L,(8.7 ± 2.2) mmol/L vs ( 19.2 ± 2.4) mmol/L,(5.8 ± 1.1 ) ％ vs (8.4 ± 1.3 ) ％ ] and in insulin group [ (6.9 ± 1.2)mmol/L vs (8.4 ± 1.2)mmol/L,(9.0 ± 1.6)mmol/L vs (18.1 ±2.6)mmol/L,(7.2 ± 1.2)％ vs (8.2 ± 1.4) ％ ] after treatment for 12 months were lower( all P ＜0.05).The levels of Homa-IRI,HbA1c,insulin dosage and hypoglycemia events in pioglitazone plus insulin group were lower than those in insulin group [ (5.8 ±1.1)％ vs (7.2 ± 1.1)％,1.16 ±0.25 vs 1.45 ±0.28,(17 ±4)U/d vs (27 ±8)U/d,(0.8 ±0.3)times vs (1.6±0.8)times] (P ＜0.05),while the difference of body weight between the two group had no statistical significance ( P ＞ 0.05).Conclusion The method of pioglitazone combined with insulin treatment can more effectively control blood sugar,reduce the dosage of the insulin and hypoglycemia events and improve insulin resistance in newly diagnosed LADA patients.
