两种联合用药方案治疗老年2型糖尿病的临床评价

Clinical evaluation of two combination drug regimens in the treatment of elderly patients with type 2 diabetes mellitus

目的评价胰岛素联合西格列汀、胰岛素联合二甲双胍治疗老年2型糖尿病的临床疗效及安全性,为临床医师选择合理用药方案提供参考。方法 100例老年2型糖尿病患者作为研究对象,采用随机信封法分为A组与B组,各50例。A组应用胰岛素联合西格列汀治疗, B组应用胰岛素联合二甲双胍治疗,比较两组患者的临床疗效。结果 A组患者空腹血糖(6.4±1.5)、餐后2 h血糖(8.6±2.4)mmol/L、糖化血红蛋白水平(7.1±1.5)%优于B组的(8.2±1.4)、(11.2±2.8)mmol/L、(8.2±1.7)%,差异有统计学意义(P<0.05)。A组患者空腹胰岛素(11.3±1.5)、餐后2 h胰岛素(76.3±8.1)mU/L、脂岛素抵抗指数(2.9±0.5)、胰岛素敏感指数(0.020±0.005)优于B组的(8.2±1.4)、(69.6±7.5)mU/L、(3.3±0.7)、(0.018±0.004),差异有统计学意义(P<0.05)。A组患者总胆固醇(TC)(4.1±0.7)mmol/L、甘油三酯(TG)(1.5±0.2)mg/dl、高密度脂蛋白胆固醇(HDL-C)(2.3±0.6)、低密度脂蛋白胆固醇(LDL-C)(2.2±0.2)mmol/L优于B组(4.8±0.8)mmol/L、(1.8±0.3)mg/dl、(1.8±0.5)、(2.6±0.3)mmol/L,差异有统计学意义(P<0.05)。A组患者总有效率为96%略高于B组的94%,差异无统计学意义(P>0.05)。结论采用胰岛素联合西格列汀治疗老年2型糖尿病疗效显著,值得临床推广应用。

Objective To evaluate the clinical efficacy and safety of Insulin combined with Sitagliptin,Insulin combined with Metformin in the treatment of elderly type 2 diabetes mellitus,and to provide reference for clinicians in choosing rational drug regimen.Methods A total of 100 elderly patients with type 2 diabetes mellitus were selected as research objects,they were divided into group A and group B by random envelope method,50 cases in each group.The group A was given Insulin combined with Sitagliptin,the group B was given Insulin combined with Metformin.The clinical curative effects of the two groups were compared.Results The fasting plasma glucose,2 h postprandial plasma glucose and glycosylated hemoglobin level of the group A were(6.4±1.5)mmol/L,(8.6±2.4)mmol/L and(7.1±1.5)%respectively,which were significantly better than(8.2±1.4)mmol/L,(11.2±2.8)mmol/L and(8.2±1.7)%of the group B,the differences were statistically significant(P<0.05).The fasting insulin,postprandial 2 h insulin,lipoidin resistance index and insulin sensitivity index of the group A were(11.3±1.5)mU/L,(76.3±8.1)mU/L,(2.9±0.5)and(0.020±0.005)respectively,which were significantly better than(8.2±1.4)mU/L,(69.6±7.5)mU/L,(3.3±0.7)and(0.018±0.004)of the group B,the differences were statistically significant(P<0.05).The total cholesterol(TC),triglyceride(TG),high density lipoprotein cholesterol(HDL-C)and low density lipoprotein cholesterol(LDL-C)of the group A were(4.1±0.7)mmol/L,(1.5±0.2)mg/dl,(2.3±0.6)mmol/L and(2.2±0.2)mmol/L respectively,which were significantly better than(4.8±0.8)mmol/L,(1.8±0.3)mg/dl,(1.8±0.5)mmol/L and(2.6±0.3)mmol/L of the group B,the differences were statistically significant(P<0.05).The total effective rate of group A was 96%,which was slightly higher than 94%of group B,the difference was not statistically significant(P>0.05).Conclusion The efficacy of Insulin combined with Sitagliptin in the treatment of elderly patients with type 2 diabetes is significant,and is worthy of clinical promotion and application.