门冬胰岛素50治疗肝源性糖尿病患者初步疗效研究

摘要

目的 观察门冬胰岛素50治疗肝源性糖尿病(HD)患者的临床疗效.方法 117例HD患者被随机分为两组,分别接受甘精胰岛素联合阿卡波糖治疗58例和门冬胰岛素50治疗59例,观察12w.观察两组患者空腹血糖(FPG)、餐后2h血糖(2hPBG)、糖化血红蛋白(HbA1c)、胰岛素用量、血糖达标时间、低血糖发生情况等指标的变化,从而比较治疗效果及其安全性.结果 在治疗12w末,门冬胰岛素50治疗组FBG为(5.97±1.26)mmol/L,与甘精胰岛素治疗组的[(5.54±1.48)mmol/L]比,无显著差异(P>0.05);门冬胰岛素50组PBG为(7.45±2.56)mmol/L,显著低于甘精胰岛素组[(8.95±2.44)mmol/L,P<0.05],HbA1c为(6.81±0.23)%,显著低于甘精胰岛素组的[(7.56±0.31)%,P<0.05],每日胰岛素用量为(37.2±7.0)U·d-1,与甘精胰岛素组的[(35.1±6.8)U·d-1]比,无显著统计学差异(P>0.05),血糖达标时间为(14.2±2.8)d,与甘精胰岛素组的[(14.5±3.2)d]比,无显著统计学差异(P>0.05),轻微低血糖发生率为3.5%,与甘精胰岛素组的5.1%比,无统计学差异(P>0.05).结论 门冬胰岛素50治疗HD患者疗效肯定,对餐后血糖的控制存在优势,且安全性良好.%Objective To assess the efficacy of biphasic insulin aspart 50 in the management of patients with hepatogenic diabetes(HD). Methods One hundred and seventeen patients with HD were recruited in this study. They were randomoly divided into glargine and acarbose group(n=58)and insulin aspart 50-treated group (n=59). The dose of insulin was adjusted according to fasting blood glucose(FBG),2 h postprandial blood glucose (2 h PBG). FBG,2 hPBG and glycosylated hemoglobin(HbAlc)were monitored for 12 weeks. Blood HbAlc, blood glucose levels,glycemic control time and incidence of hypoglycemia were compared between the two groups. Results At the end of 12 weeks,FBG level in insulin aspart 50-treated group was(5.97 ±1.26)mmol/L,not significantly different as compared to(5.54±1.48)mmol/L in glargine-treated group(P>0.05),while the PBG level was(7.45±2.56)mmol/L,significantly lower than(8.95±2.44)mmol/L in glargine group(P<0.05);meanwhile,the HbA1c level was(6.81±0.23)%,significant lower than(7.56±0.31)% in glargine group(P<0.05);the dose of insulin was (37.2±7.0)U·d-1in insulin aspart 50 group,not significantly different as compared to(35.1±6.8)U·d-1in glargine group(P>0.05);the glycemic control time was(14.2±2.8)d in insulin aspart 50 injection group,not significantly different as compared to(14.5±3.2)d in glargine group(P>0.05);the incidence of hypoglycemia was 3.5% in insulin aspart injection group,not significantly different as compared to 5.1% in glargine group(P>0.05). Conclusion Biphasin insulin aspart 50 therapy is effective and safe for patients with HD.