摘要
目的比较罗格列酮与格列美脲联合胰岛素治疗首次诊断2型糖尿病的临床疗效及安全。方法研究对象选取初诊T2DM患者共150例，采用随机数字表法分为罗格列酮组（75例）和格列美脲组（75例），分别在胰岛素注射基础上给予罗格列酮和格列美脲辅助治疗；比较两组患者血糖控制达标时间，胰岛素注射量，治疗前后提质量指数（BMI）、空腹血糖（FBG）、餐后2h血糖（2hFBG）、糖化血红蛋白（HbAlc）、空腹C．肽（FC．P）、餐后2hC肽（2hC．P）、胰岛素抵抗指数（HOMA-IR）、胰岛素功能指数（HOMA-islet）水平及低血糖发生率等。结果两组患者血糖控制达标时间和胰岛素注射量比较差异无统计学意义（P〉0．05）；罗格列酮组治疗前后BMI水平分别为（25．03±3．25）kg／m2、（27．42±3．49）kg／m2；格列美脲组治疗前后BMI水平分别为（24．71±3．18）kg／m2、（24．80±3．30）kg／m2；格列美脲组患者治疗后BMI水平显著低于罗格列酮组（t=3．37，P〈0．05）；两组患者治疗后BMI、FBG、2hFBG、HbAlc、FC-P、2hC—P、HOMA—IR及HOMA-islet水平组间比较差异无统计学意义（P〉0．05）；同时罗格列酮组和格列美脲组低血糖发生率分别为14．67％、2．67％；格列美脲组低血糖发生率显著低于罗格列酮组（x2=7．15，P〈0．05）。结论两种药物辅助胰岛素治疗首次诊断2型糖尿病在控制血糖水平和改善胰岛功能方面效果接近，但格列美脲应用有助于避免体质量增加和低血糖发生，价值优于罗格列酮。
Objective To compare the clinical effects and safety of rosiglitazon and gfimepiride separately combined with insulin in the treatment of patients with T2DM for first diagnosed. Methods 150 patients with T2DM for first diagnosed were chosen and randomly divided into two groups aeeording to digital table, including rosiglitazon group （60 patients） with rosiglitazon, and glimepiride group （60 patients） with glimepiride on the basis of glargine insulin. The compliance time of blood glucose, the insulin used doses, the levels of BMI, FBG ,2hFBG, HbA1 c, FC - P, 2hC - P, HOMA - IR and HOMA - islet before and after treatment and hypoglycemia incidence of both two groups were compared. Results There were no statistically significant differences in the compliance time of blood glueose and the insulin used doses between 2 groups （ P 〉 0.05 ）. The levels of BMI before and after treatment of the glimepiride group were （ 25.03 ± 3.25 ） kg/m2, （ 27.42 ±3.49 ） kg/m2, respectively, which of the rosiglitazon group were （ 24.71 ± 3.18 ） kg/m2, （ 24.80 ± 3.30 ） kg/m2, respectively. The BMI after treatment of the glimepiride group was significantly lower than that of the rosiglitazon group（ t = 3.37 ,P 〈 0.05 ）. There were no statistically significant differences in the levels of FBG, 2hFBG, HbA1 e, FC - P, 2hC - P, HOMA - IR and HOMA - islet between the two groups（all P 〉 0.05 ）. The incidence rates of hypoglycemia in the rosiglitazon group and glimepiride group were 14. 67% ,2.67% , respeetively. The ineidenee rate of hypoglycemia of the glimepiride group was significantly lower than that of the rosiglitazon group （ X2 = 7. 15, P 〈 0. 05 ）. Conclusion Rosiglitazon and glimepiride separately combined with insulin in the treatment of patients with T2DM for first diagnosed possess the same elinieal effects in controlling the blood glucose levels and improving the islet function ; and glimepiride applieation can efficiently prevent the weight gain amount and hypoglycemia.
作者
魏怡静
薛威阳
Wei Yijing Xue Weiyang(Department of Pharmacy, the People＇s Hospital of Changxing County, Zhejiang 313100, China)
出处
《中国基层医药》
CAS
2017年第21期3314-3317,共4页
Chinese Journal of Primary Medicine and Pharmacy
