恩格列净联合德谷胰岛素对2型糖尿病患者糖脂代谢指标及胰岛β细胞功能的影响

To Investigate the Effects of Empagliflozin Combined with Insulin Degludec on Glucose and Lipid Metabolism and IsletβCell Function in Patients with Type 2 Diabetes Mellitus

目的 探讨恩格列净联合德谷胰岛素对2型糖尿病(T2DM)患者糖脂代谢指标及胰岛β细胞功能的影响。方法 按随机数字表法将88例2021年10月至2022年12月浔阳区人民医院收治的T2DM患者分为两组,各44例。对照组予以德谷胰岛素治疗,研究组在对照组基础上加用恩格列净治疗。对比两组临床疗效,血糖代谢指标,血脂代谢指标,胰岛β细胞功能指标[胰岛素分泌指数(HOMA-β)、β细胞功能指数(MBCI)],胰岛素抵抗指数(HOMA-IR),血清因子[血清心钠素(ANP)、内皮素-1(ET-1)、基质金属蛋白酶-9(MMP-9)、丙二醛(MDA)]水平和不良反应发生率。结果 研究组临床总有率高于对照组高(P<0.05)。治疗后,研究组血糖代谢指标低于对照组(P<0.05);研究组高密度脂蛋白胆固醇(HDL-C)水平较对照组高,低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、甘油三酯(TG)水平较对照组低(P<0.05);研究组HOMA-β、MBCI较对照组高,HOMA-IR较对照组低(P<0.05)。组间不良反应发生率比较差异无统计学意义(P>0.05)。结论 恩格列净联合德谷胰岛素治疗T2DM患者可增强疗效,纠正糖脂代谢紊乱,在改善胰岛β细胞功能的同时,缓解内皮损伤和氧化应激损伤,且具有较高的用药安全性。

Objective To investigate the effects of empagliflozin combined with insulin degludec on glucose and lipid metabolism and isletβcell function in patients with type 2 diabetes mellitus(T2DM).Methods 88 patients with T2DM admitted to Xunyang District People's Hospital from October 2021 to December 2022 were divided into two groups using a random number table method,with 44 patients in each group.The control group was treated with insulin degludec,and the study group was treated with empagliflozin on the basis of the control group.Compare the clinical efficacy,blood glucose metabolism indicators,blood lipid metabolism indicators,and pancreatic islets between two groupsβcellular function indicators(insulin secretion index HOMA-β),βcell function index(MBCI),insulin resistance index(HOMA-IR),serum factors[serum atrial natriuretic peptide(ANP),endothelin-1(ET-1),matrix metalloproteinase-9(MMP-9),malondialdehyde(MDA)]levels,and incidence of adverse reactions.Results The total clinical rate of the study group was higher than that of the control group(P<0.05).After treatment,the blood glucose metabolism index of the study group was lower than that of the control group(P<0.05);the levels of high-density lipoprotein cholesterol(HDL-C)in the study group were higher than those in the control group,while the levels of low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),and triglycerides(TG)were lower than those in the control group(P<0.05);HOMA-β,MBCI were higher than in the control group,while HOMA-IR was lower than the control group(P<0.05);Comparison of incidence of adverse reactions between groups(P>0.05).Conclusion Empagliflozin combined with insulin degludec in the treatment of T2DM can enhance the efficacy,correct glucose and lipid metabolism disorders,improve isletβcell function,relieve endothelial injury and oxidative stress injury,and has high drug safety.