麦芽糖注射液对2型糖尿病糖脂代谢和胰岛素分泌影响的研究

A study on maltose injection to influence glycolipid metabolism and insulin secretion in type 2 diabetic

目的探讨麦芽糖注射液对2型糖尿病血糖、脂质代谢及胰岛素分泌的影响,并评价其供能的有效性。方法59例2型糖尿病患者随机分为麦牙糖组和氯化钠组,分别静脉输注10%麦芽糖注射液或0.9%氯化钠注射液各500 ml。观察输注前后血糖(BG)、血C肽、血游离脂肪酸(FFA)、血酮体、尿糖及尿酮变化。结果①麦芽糖组(A组)用药后1、2、3、5h静脉血糖均较用药前有所增加,其增量分别为(0.04±0.82)mmol/L、(0.39±1.19)mmol/L、(0.50±1.37)mmol/L、(0.14±1.24)mmo1/L,氯化钠组(B组)则较用药前有所下降,其血糖下降值各为(0.93±1.05)mmol/L、(1.12±1.05)mmol/L、(1.28±1.05)mmol/L、(1.66±1.20)mmol/L,两组比较差异有统计学意义(P<0.01);②两组用药后5 h内血浆游离脂肪酸(FFA)及血酮体均有下降,但氯化钠组下降不如麦芽糖果组明显,两组比较差异有统计学意义;③麦芽糖组用药后C肽及尿糖水平有所增加,尿酮治疗前后变化两组差异无统计学意义(P>0.05)。结论麦芽糖注射液用于2型糖尿病患者,在提供能量时未引起血、尿酮体升高,还能降低血FFA浓度,虽然开始治疗5h内血糖水平有所提高,但其升值幅度不大,故在监测血糖情况下,使用是安全的。

Objective To observe the influence of the maltose injection in the treatment of type 2 diabetes mellitus on the levels of blood glucose （BG）, free fatty acid （FFA）, C-peptide, blood and urine ketone, and to evaluate its efficacy and safety. Methods Fifty-nine patients with type 2 diabetes mellitus were divided into two groups and received randomizd, placebo-controlled study with maltose injection（group A） or sodium chloride（group B）. Results Maltose injection increased slightly the blood glucose levels in the first 5 hours after treatment compared with sodium chloride group; the elevated value were （0.04±0.82）mmol/L,（0.39±1.19）mmol/L, （0.50±1.37）mmol/L, （0.14±1.24）mmol/L in group A, and the decreased value were （0.93±1.05）mmol/L, （1.12±1.05）mmol/L, （1.28±1.05）mmol/L, （1.66±1.20）mmol/L in group B（P〈0.01）. The urine glucose levels were elevated 3 hours after the maltose injection. Free fatty acid（FFA） and blood ketone decreased in the both groups in the first 5 hours, especially in the maltose injection group. C-peptide value increased after treatment with maltose injection, urine ketone levels did not change markedly. Conclusion Maltose injection is a compatible fluid for type 2 diabetic patients; its energy-supply did not make the blood or urine keto-bodies run up, it even let the blood FFA have a drop;though its initial action made a five-hour high sugar level, the rise was mild; therefore under a blood sugar surveillance its use is safe.