诺和平联合阿卡波糖治疗老年初发型2型糖尿病对T细胞亚群及胰岛β细胞功能的影响

Effect on T cell subsets and function of islet β cells of levemir combined with acarbose in elder patients with early-onset type 2 diabetes mellitus

目的:探讨诺和平联合阿卡波糖治疗老年初发型2型糖尿病(T_2DM)对T细胞亚群与胰岛β细胞功能的影响。方法:选择老年初发型T2DM患者100例,按照入组序列号奇偶数分为对照组与观察组各50例,其中对照组给予诺和灵联合阿卡波糖治疗,观察组给予诺和平皮下注射联合阿卡波糖治疗,比较两组患者治疗前(T_0)、治疗4周(T_1)、8周(T_2)T细胞亚群水平与胰岛β细胞功能指标。结果:(1)两组患者T_0、T_1、T_2CD3^+、CD3^+、CD3^+/CD8^+水平呈升高趋势,CD8^+呈下降趋势,其中观察组T_1、T_2CD3^+、CD3^+、CD3^+/CD8^+水平明显高于对照组,CD8^+低于对照组,比较差异有统计学意义(P<0.05);(2)两组患者T_0、T_1、T_2FPG、HbA1c、HOMA-IR水平呈下降趋势,FIns、HOMA-B水平呈升高趋势,其中观察组T_1、T_2FPG、HbA1c、HOMA-IR水平明显低于对照组,FIns、HOMA-B高于对照组,比较差异有统计学意义(P<0.05);(3)对照组发生低血糖3例,不良反应发生率为6%,观察组无不良反应发生,比较差异有统计学意义(P<0.05)。结论:诺和平联合阿卡波糖治疗老年初发型T2DM有助于改善机体免疫功能,保护胰岛β细胞功能。

Objective：To discuss the effect of the combined therapy of levemir and acarbose on T cell subsets and function of islet β cells in elder patients with early-onset type 2 diabetes mellitus.Methods：According to the number parity of entry sequence,100 cases of elder patients with early-onset type 2 diabetes mellitus were divided into the control group and the observation group with 50 cases in each group.The control group was treated with novolin and acarbose,while the observation group was given subcutaneous injection of levemir and acarbose treatment.The T cell subsets and function of islet β cells in two group of patients before the treatment（T0）,treatment for 4 weeks（T1）,treatment for 8 weeks（T2）were compared.Results：（1）The levels of T0,T1,T2CD3,CD3＋,CD3＋/CD8＋ were increased in both groups,and CD8＋ decreased.Among them,the levels of T1,T2CD3＋,CD3＋,CD3＋/CD8＋ of the observation group were significantly higher than the control group,and the level of CD8＋ was significantly lower than the control group（P〈0.05）;（2）In the stage of T0,T1,T2,the levels of FPG,HbA1c,HOMA-IR showed a downward trend,the levels of Fins,HOMA-B were increased.In these two groups,the levels of T1,T2 FPG,HbA1c,HOMA-IR of the observation group were significantly lower than the control group,and the levels of Fins,HOMA-B were significantly higher than the control group（P〈0.05）;（3）In the control group occurred 3 cases of hypoglycemia,and the incidence of adverse reactions was 6%.However,in the observation group no occurred adverse reactions,the difference was statistically significant（P〈0.05）;Conclusions：The combined therapy of levemir and acarbose in elder patients with early-onset type 2 diabetes mellitus.It helps to improve immune function and protect the islet β-cell function.