利格列汀联合门冬胰岛素50治疗肝源性糖尿病的效果观察

Clinical effect of linagliptin combined with insulin aspart 50 in treatment of hepatogenous diabetes

目的观察利格列汀联合门冬胰岛素50治疗肝源性糖尿病(HD)的疗效和安全性。方法选取2014年10月-2016年2月于辽宁省人民医院就诊的HD患者57例。随机分为门冬胰岛素50治疗组(A组,28例),利格列汀联合门冬胰岛素50治疗组(B组,29例),比较2组基线水平和治疗12周后血糖、胰岛素、C肽、葡萄糖处置指数(DI)、糖化血红蛋白、胰高血糖素、胰岛素日剂量,观察低血糖事件及其他不良反应。计量资料组内比较采用配对t检验,组间比较采用成组t检验,计数资料组间比较采用χ~2检验。结果治疗12周后,2组4个时间点血糖较治疗前下降,差异均有统计学意义(t=5.357~21.380,P值均<0.05),30、60、120min胰岛素高于治疗前,差异均有统计学意义(t=2.222~6.491,P值均<0.05)。B组糖化血红蛋白、胰高血糖素、胰岛素日剂量、30、60、120 min血糖和胰岛素值低于A组,差异均有统计学意义(t=3.136~15.096,P值均<0.05),DI、4个时间点C肽值高于A组,差异均有统计学意义(t=2.994~10.813,P值均<0.05)。A组低血糖事件发生率(28.6%)高于B组(3.4%),差异有统计学意义(χ~2=5.005,P<0.05)。结论利格列汀联合门冬胰岛素50治疗HD能更有效控制血糖,且安全。

Objective To investigate the clinical effect and safety of linagliptin combined with insulin aspart 50 in the treatment of hepatogenous diabetes （HD）. Methods A total of 57 patients with HD who visited The People＇s Hospital of Liaoning Province from October 2014 to February 2016 were enrolled and randomly divided into insulin aspart 50 group （group A, 28 patients） and linagliptin combined with in- sulin aspart 50 group （ group B, 29 patients）. The two groups were compared in terms of blood glucose, insulin, C - peptide, glucose disp~,- sition index （DI）, glycosylated hemoglobin Alc （HbAlc） , glucagon, and daily insulin dose at baseline and after 12 weeks of treatment. The adverse events including hypoglycemia were observed. The paired t - test was used for comparison of continuous data within one group, and the independent - samples t test was used for comparison of continuous data between groups ; the chi - square test was used for compari- son of categorical data between groups. Results After 12 weeks of treatment, both groups had significant reductions in blood glucose at four time points （t =5. 357- 21. 380, all P 〈 0.05 ） and significant increases in the insulin level at 30, 60, and 120 minutes （t = 2. 222 - 6. 491, all P 〈0.05 ）. Compared with group A, group B had significantly lower levels of HbAlc and glucagon, daily insulin dose, and blood glucose and insulin levels at 30, 60, and 120 minutes （ t = 3. 136 - 15. 096, all P 〈 0.05 ） , as well as significantly higher DI and lev- els of C - peptide at four time points （ t = 2. 994 - 10. 813, all P 〈 0.05 ）. Group A had a significantly higher incidence rate of hypoglycemia than group B （28.6% vs 3.4%, X2 = 5. 005, P 〈 0.05 ）. Conclusion Linagliptin combined with insulin aspart 50 can effectively control blood glucose in patients with HD and has good safety.