CAJ | 학술논문

目的观察依帕司他联合胰岛素治疗对初诊糖尿病患者胰岛β细胞功能的影响.方法 45例初诊糖尿病患者,按数字表法随机分组采用4次皮下胰岛素强化治疗(RI组)、依帕司他联合4次皮下胰岛素强化治疗(RI +EP组),并进行3个月的治疗和随访观察,比较各组治疗前、治疗3个月的空腹血糖(FPG)、餐后2 h 血糖(2 h PG)、空腹胰岛素(FINS)、餐后2h胰岛素(2 h INS)、糖化血红蛋白(HbA1C)、超氧化物歧化酶(SOD)、血清丙二醛(MDA)水平和胰岛素抵抗指数(HOMA-IR)、胰岛素释放指数(HOMA-β)值.结果 RI组22例、RI +EP组23例均完成了治疗3个月的随访评估.两组治疗后FPG、2hPG、HbA1C、MDA水平及HOMA-IR均较治疗前下降,血清FINS、2 h INS、SOD水平及HOMA-β高于治疗前,差异均有统计学意义(均P ＜0.05).治疗后RI +EP组的FINS、2 h INS、SOD及HOMA-β高于RI组,MDA低于RI组,差异均有统计学意义(t=3.228、2.536、3.021、2.343、2.122,均P＜0.05),FPG、2hPG、HbA1C、HOMA-IR两组差异均无统计学意义(均P＞0.05).线性回归分析结果表明,HOMA-β与SOD水平均呈正相关(r=0.888,r2=0.783,均P＜0.01).结论依帕司他联合胰岛素治疗初诊糖尿病,有效抑制氧化应激,改善胰岛β细胞功能,效果优于单用胰岛素治疗.
목적 관찰의파사타연합이도소치료대초진당뇨병환자이도β세포공능적영향.방법 45례초진당뇨병환자,안수자표법수궤분조채용4차피하이도소강화치료(RI조)、의파사타연합4차피하이도소강화치료(RI +EP조),병진행3개월적치료화수방관찰,비교각조치료전、치료3개월적공복혈당(FPG)、찬후2 h 혈당(2 h PG)、공복이도소(FINS)、찬후2h이도소(2 h INS)、당화혈홍단백(HbA1C)、초양화물기화매(SOD)、혈청병이철(MDA)수평화이도소저항지수(HOMA-IR)、이도소석방지수(HOMA-β)치.결과 RI조22례、RI +EP조23례균완성료치료3개월적수방평고.량조치료후FPG、2hPG、HbA1C、MDA수평급HOMA-IR균교치료전하강,혈청FINS、2 h INS、SOD수평급HOMA-β고우치료전,차이균유통계학의의(균P ＜0.05).치료후RI +EP조적FINS、2 h INS、SOD급HOMA-β고우RI조,MDA저우RI조,차이균유통계학의의(t=3.228、2.536、3.021、2.343、2.122,균P＜0.05),FPG、2hPG、HbA1C、HOMA-IR량조차이균무통계학의의(균P＞0.05).선성회귀분석결과표명,HOMA-β여SOD수평균정정상관(r=0.888,r2=0.783,균P＜0.01).결론 의파사타연합이도소치료초진당뇨병,유효억제양화응격,개선이도β세포공능,효과우우단용이도소치료.
Objective To observe the influence of epalrestat combined with insulin therapy on islet beta cell function in newly diagnosed type 2 diabetic patients.Methods 45 newly diagnosed type 2 diabetic patients were randomly treated with 4 times of subcutaneous insulin therapy(RI group) or epalrestat plus 4 times of subcutaneous insulin therapy(RI + EP group).Patients were followed up for 3 months.The fasting blood-glucose (FPG),the 2 hour postprandial blood glucose (2 h PG),fasting insulin (FINS),the 2 hour postprandial blood insulin (2 h INS),glycated hemoglobin (HbA1 C),superoxide dismutase (SOD),malondialdehyde (MDA),insulin resistance index (HOMA-IR) and insulin release index(HOMA-β) were observed at 3th month after the initiation of therapy.Results Follow-up evaluation of 22 cases in RI group,23 cases in group RI + EP were completed 3 months of treatment.After treatment,FPG,2 h PG,HbA1 C,MDA and HOMA-IR in the two groups were decreased than those before treatment,the serum FINS,2 h INS,SOD and HOMA-β were higher than those before treatment,the differences were statistically significant (all P ＜0.05).After treatment,FINS,2 h INS,SOD and HOMA-β of RI + EP group were higher than those in RI group,MDA was lower than that of RI group,the differences were statistically significant (t =3.228,2.536,3.021,2.343,2.122,all P ＜ 0.05).FPG,2 h PG,HbA1 C,HOMA-IR between the two groups had no significant differences (all P ＞ 0.05).Linear regression analysis showed that HOMA-β was positively correlated with SOD level (r =0.888,r2 =0.783,all P ＜ 0.01).Conclusion The results suggest that epalrestat combined with insulin therapy can inhibit oxidative stress,and improve islet beta cell function in newly diagnosed type 2 diabetic patients,and its clinical effect is better than monotherapy with insulin.