论文部分内容阅读
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 efficacy of continuous subcutaneous insulin infusion (CSII) and metformin or pioglitazone in hospitalized patients with T2DM with short course of disease and to explore the optimal treatment of T2DM with short course of disease. Methods A total of 73 patients with T2DM were randomly divided into CSII group (23 cases), CSII combined with metformin group (26 cases) and CSII combined with pioglitazone group (24 cases). The levels of FPG, Ins, C-P, hsC-RP and 2hPG, Ins, C-P in 75g glucose loading group were determined before and after intensive treatment for 2 weeks. The steady-state model was used to calculate the β-cell function (HOMA-β) and insulin resistance index (HOMA-IR). At the same time, the change of each index and the treatment cost were compared between the three groups. Results Compared with CSII group, the levels of HOMA-β in CSII + Met group and CSII + Pio group were significantly increased (P <0.05) and HOMA-IR level was significantly decreased (P <0.05) , CSII + Pio group significantly shorter blood glucose compliance time, insulin dosage and treatment costs decreased significantly (P <0.05). Conclusion CSII combined with metformin or combined with pioglitazone can effectively improve pancreatic β-cell function and reduce insulin resistance in T2DM patients. CSII and metformin can significantly reduce insulin dosage and treatment costs.