中效人胰岛素联合瑞格列奈治疗磺脲类降糖药继发性失效临床观察

CLINICAL OBSERVATION OF NEUTRAL PROTAMINE HAGEDORN PLUS REPAGLINID IN SFS TREATMENT

目的观察中效人胰岛素与瑞格列奈联合应用治疗磺脲类降糖药继发性失效的疗效。方法将磺脲类降糖药继发性失效(SFS)36例病例随机分成两组,分别接受睡前小剂量中效人胰岛素加瑞格列奈(A组,20例)和单纯瑞格列奈(B组,16例)治疗,比较两组各生化指标。结果①治疗前空腹血糖(FPG)、餐后2小时血糖(2hPG)、C肽(C-P)、糖化血红蛋白(HbA1c)水平两组间无统计学差异;②治疗3个月后两组自身的FPG、2hPG、C-P、HbA1c水平均较治疗前明显改善,P值分别为0.01、0.05、0.05、0.01;③治疗3个月后FPG、2hPG、C-P、HbA1c水平A组均低于B组,P值分别<0.01、0.05、0.05、0.01。结论中效人胰岛素联合瑞格列奈和单用瑞格列奈治疗磺脲类降糖药继发性失效均有疗效,胰岛素和瑞格列奈联用优于单用瑞格列奈。

Objective Observe the clinical effects of neutral protamine hagedom （NPH） plus Repaglinide on the patients with secondary failure of sulfonylurea （SFS）. Methods 36 patients with SFS were randomly assigned to receive subcutaneous injection with little dose NPH before sleep, and plus oral Repaglinide （Group A, 20 patients） or oral Repaglinide alone （Group B, 16 patients）, and to compare the biochemical indexes between group A and B. Results ① The values of FPG, 2hPG, G-P, and HbA1c were similar between the group A and B before treatment.② The FPG, 2hPG, C-P, and HbA1c in each groups were improvement significantly alter 3 months of treatment, P = 0.01, 0.05, 0.05 and 0.01 respectively.③ The FPG, 2hPG, C-P, and HbA1c in group A were all lower than that in group B after 3 months treatment, P=0.01, 0.05, 0.05 and 0.01 respectively. Conclusion The patients with SFS were all efficacy who received NPH human insulin plus Repaglinide or Repaglinide alone orally. NPH plus Repaglinide is better.