2型糖尿病应用甘精胰岛素联合瑞格列奈治疗的效果分析

Effect analysis of insulin glargine combined with repaglinide in treatment of type 2 diabetes mellitus

目的分析2型糖尿病应用甘精胰岛素联合瑞格列奈治疗的临床效果。方法80例2型糖尿病患者,随机分为常规组和研究组,各40例。常规组患者采用甘精胰岛素治疗,研究组患者采用甘精胰岛素联合瑞格列奈治疗。对比两组患者不良反应发生情况及治疗前后胰岛功能指标[空腹C肽(FCP)、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)及空腹胰岛素(FINS)]、血糖[空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)]水平、炎性因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)]水平、生活质量评分。结果研究组不良反应发生率5.00%低于常规组的22.50%,差异有统计学意义(P<0.05)。治疗后,研究组FCP(3.11±0.25)nmol/L、HOMA-β(7.36±0.22)及FINS(13.33±1.24)μU/L均高于常规组的(2.42±0.24)nmol/L、(4.35±0.18)、(10.32±1.23)μU/L,HOMA-IR(3.32±0.27)低于常规组的(5.34±0.25),差异有统计学意义(P<0.05)。治疗后,研究组FPG(4.22±1.14)mmol/L、2 h PG(6.75±1.14)mmol/L、HbA1c(5.65±1.25)%均低于常规组的(5.65±1.11)mmol/L、(7.72±1.13)mmol/L、(7.43±1.23)%,差异有统计学意义(P<0.05)。治疗后,研究组TNF-α(3.41±0.25)ng/L、IL-6(62.36±3.22)ng/L、hs-CRP(1.32±0.27)mg/L均低于常规组的(5.42±0.24)ng/L、(108.35±3.18)ng/L、(2.74±0.25)mg/L,差异有统计学意义(P<0.05)。治疗后,研究组躯体健康、社会功能、精神健康以及生理功能评分分别为(65.56±1.52)、(55.34±1.22)、(64.32±1.25)、(62.14±1.25)分,均高于常规组的(38.76±1.44)、(39.25±1.13)、(41.23±1.21)、(43.64±1.24)分,差异有统计学意义(P<0.05)。结论2型糖尿病患者应用甘精胰岛素联合瑞格列奈进行治疗,可有效降低患者血糖水平、炎性因子水平以及不良反应发生率,改善患者胰岛功能与生活质量,药学效果显著。

Objective To analyze the clinical effect of insulin glargine combined with repaglinide in treatment of type 2 diabetes mellitus.Methods A total of 80 patients with type 2 diabetes mellitus were randomly divided into conventional group and study group,with 40 cases in each group.The conventional group was treated with insulin glargine,and the study group was treated with insulin glargine and repaglinide.Both groups were compared in terms of occurrence of adverse reactions,islet function indexes[fasting C-peptide(FCP),Homeostasis Model Assessment of β Cell Function(HOMA-β),Homeostasis Model Assessment Insulin Resistance Index(HOMA-IR)and fasting insulin(FINS),fasting plasma glucose(FPG),2 h postprandial glucose(2 h PG)and glycated hemoglobin(HbA1c)]levels,inflammatory factors[tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)]levels and quality of life score before and after treatment.Results The incidence of adverse reactions in the study group was 5.00%,which was lower than that of 22.50% in the conventional group,and the difference was statistically significant(P<0.05).After treatment,the study group had FCP of(3.11±0.25)nmol/L,HOMA-β of(7.36±0.22)and FINS of(13.33±1.24)μU/L,which were higher than those of(2.42±0.24)nmol/L,(4.35±0.18)and(10.32±1.23)μU/L in the conventional group;HOMA-IR of(3.32±0.27)in the study group was lower than that of(5.34±0.25)in the conventional group;the differences were statistically significant(P<0.05).After treatment,the study group had FPG of(4.22±1.14)mmol/L,2 h PG of(6.75±1.14)mmol/L and HbA1c of(5.65±1.25)%,which were lower than those of(5.65±1.11)mmol/L,(7.72±1.13)mmol/L and(7.43±1.23)% in the conventional group,and the differences were statistically significant(P<0.05).After treatment,the study group had TNF-αof(3.41±0.25)ng/L,IL-6 of(62.36±3.22)ng/L and hs-CRP of(1.32±0.27)mg/L,which were lower than those of(5.42±0.24)ng/L,(108.35±3.18)ng/L and(2.74±0.25)mg/L in the conventional group,and the differences were statistically significant(P<0.05).After treatment,the scores of physical health,social function,mental health and physical function were(65.56±1.52),(55.34±1.22),(64.32±1.25)and(62.14±1.25)points,which were higher than those of(38.76±1.44),(39.25±1.13),(41.23±1.21)and(43.64±1.24)points in the conventional group,and the differences were statistically significant(P<0.05).Conclusion For patients with type 2 diabetes mellitus,insulin glargine combined with repaglinide can effectively reduce the level of blood glucose,the level of inflammatory factors and the incidence of adverse reactions,improve the islets function and quality of life of patients,and the pharmaceutical effect is significant.