糖尿病患者急性心肌梗死后应用重组人胰岛素和人胰岛素类似物降糖治疗效果比较

The comparison of therapeutic effects between recombinant human insulin(RHI) and human insulin analogue(HIA) treatment in patients with AMI and diabetes

目的比较糖尿病患者急性心肌梗死(AMI)后使用重组人胰岛素(RHI)和人胰岛素类似物降糖治疗的效果。方法选择合并糖尿病的AMI患者32例,分为RHI组18例,地特胰岛素(Det)联合门冬胰岛素(Asp)组(Det+Asp组)14例。比较两组出院时及出院1个月后血糖控制水平,住院期间及出院后1个月内的低血糖发生率;并比较两组在出院后1个月内体重的变化。结果出院时及出院1个月后Det+Asp组FPG、2hPG均低于RHI组(P<0.01);住院期间及出院后1个月内Det+Asp组低血糖发生率均少于RHI组(P<0.05)。Det+Asp组体重增加少于RHI组(P=0.046)。两组间胰岛素用量及住院天数无差异。两组在观察期内均无新发心血管事件。结论合并糖尿病的AMI患者使用Det联合Asp治疗更有利于血糖控制,可降低低血糖发生率,并减少体重增加。

Objective To compare the therapeutic effects between RHI and insulin analogues detemir plus aspart in patients with acute myocardial infarction and diabetes. Methods 32 acute myocardial infarction patients with diabetes were randomly divided into two groups. Group A （n =-18） received human insulin therapy, and group B （n= 14） received detemir and aspart therapy. The blood glucose, incidence rates of hypoglycemia and body weight were compared between two groups. Results FPG and 2hPG were lower in group B than in group A on discharge （P〈0. 02）. After one month of discharge, the FPG and 2hPG were lower in group B than in group A （P〈0. 02）. The incidence rate of hypoglycemia was lower in group B than in group A during hospitalization （P=0. 040） and at one month of discharge （P=0. 032）. And the body weight increment was less in group B than in group A （P= 0. 046）. There were no differences in the doses of insulin and in hospitalization days between two groups. There was no new cardiovascular event in two groups. Conclusion The therapy with detemir and aspart in patients with acute myocardial infarction and diabetes can lead to the better blood glucose control, the lower incidence rate of hypoglycemia, and the less weight increment.