西格列汀联合门冬胰岛素治疗老年T2DM合并颈动脉粥样硬化患者的疗效观察

Efficacy of Sitagliptin Combined with Insulin Aspart in Treating Elderly Patients with T2DM Complicated with Carotid Atherosclerosis

目的:探讨西格列汀联合门冬胰岛素治疗老年2型糖尿病(T2DM)合并颈动脉粥样硬化患者的疗效。方法:选取2019年7月-2021年5月郑州市第七人民医院内分泌老年病科收治的86例T2DM合并颈动脉粥样硬化患者,按随机数字表法分为观察组(西格列汀联合门冬胰岛素治疗,n=40)和对照组(门冬胰岛素治疗,n=46),比较两组空腹血糖(FPG)、餐后2h血糖(2h PG)、空腹糖化血红蛋白(Hb A1C)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、颈动脉中膜厚度(CIMT)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)及不良反应发生情况。结果:观察组FPG、2h PG、Hb A1C低于对照组,FINS高于对照组,差异有统计学意义(P<0.05);两组治疗前后HOMA-IR比较,差异无统计学意义(P>0.05);观察组TC、TG、LDL-C、CIMT低于对照组,HDL-C高于对照组,差异有统计学意义(P<0.05);两组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论:西格列汀联合门冬胰岛素治疗老年T2DM合并颈动脉粥样硬化患者有助于控制血糖、血脂,延缓颈动脉粥样硬化进展,且联合治疗不增加不良反应发生概率,安全性较高。

Objective:To explore the efficacy of sitagliptin combined with insulin aspart in the treatment of elderly patients with type 2 diabetes mellitus(T2DM)complicated with carotid atherosclerosis.Methods:A total of 86 patients with T2DM complicated with carotid atherosclerosis treated in department of endocrinology and geriatrics of the 7th People’s Hospital of Zhengzhou were selected between July 2019 and May 2021.They were divided into observation group(sitagliptin combined with insulin aspart,n=40)and control group(insulin aspart,n=46)according to the random number table method.Fasting plasma glucose(FPG),postprandial 2h blood glucose(2hPG),fasting glycated hemoglobin(HbA1C),fasting insulin(FINS),homeostasis model assessment of insulin resistance(HOMA-IR),carotid intima-media thickness(CIMT),total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C),and low-density lipoprotein cholesterol(LDL-C)and occurrence of adverse reactions were compared between the two groups.Results:The levels of FPG,2hPG,and HbA1C in observation group were lower than those in control group while the level of was higher than that in control group(P<0.05).There was no statistical difference in HOMA-IR between the two groups before and after treatment(P>0.05).The TC,TG,LDL-C and CIMT in observation group were lower while the HDL-C was higher than compared to control group(P<0.05).There was no statistical significance in the total incidence rate of adverse reactions between the two groups(P>0.05).Conclusion:Sitagliptin combined with insulin aspart in the treatment of elderly patients with T2DM complicated with carotid atherosclerosis helps control the blood glucose and blood lipids,and delay the progression of carotid atherosclerosis.The combined treatment does not increase the incidence rates of adverse reactions,with high safety.