门冬胰岛素联合地特胰岛素治疗儿童糖尿病的临床效果

Therapeutic efficacy of insulin aspart combined with insulin detemir in treatment of pediatric diabetes mellitus

目的 观察门冬胰岛素联合地特胰岛素治疗儿童糖尿病的临床效果。方法 2022年11月至2023年8月天津市儿童医院(天津大学儿童医院)收治的1型儿童糖尿病患者共138例为此次试验对象,采用随机数表法将其分成两组。对照组69例应用精蛋白生物合成人胰岛素注射液治疗,研究组69例应用门冬胰岛素联合地特胰岛素治疗。治疗后对比两组患者临床疗效、血糖水平、血脂水平及低血糖发生情况。结果 在总有效率方面,研究组(91.30%)较对照组(72.47%)高(χ^(2)=8.256,P<0.05)。治疗后,两组糖化血红蛋白、空腹血糖、餐后2 h血糖均下降,且研究组[分别为(6.03±1.20)%,(6.14±1.32) mmol·L^(-1),(7.55±2.01) mmol·L^(-1)]低于对照组[分别为(7.67±1.49)%,(7.34±2.06) mmol·L^(-1),(9.36±3.15) mmol·L^(-1)](t=7.121、4.074、4.024,均P<0.05)。治疗后,两组高密度脂蛋白胆固醇水平均较治疗前上升,低密度脂蛋白胆固醇、总胆固醇、甘油三酯水平均较治疗前下降,且研究组[分别为(1.72±0.63)mmol·L^(-1),(4.31±0.65) mmol·L^(-1),(1.59±0.85) mmol·L^(-1),(1.44±0.47) mmol·L^(-1)]优于对照组[分别为(1.38±0.47) mmol·L^(-1),(5.26±0.74) mmol·L^(-1),(2.25±0.94) mmol·L^(-1),(2.06±0.54) mmol·L^(-1)](t=3.593、8.012、4.326、7.194,均P<0.05)。治疗后,研究组低血糖发生次数及发生率[分别为(0.75±0.17)次/周,8.70%]均低于对照组[分别为(1.19±0.21)次/周,28.99%],血糖水平[(3.58±0.16) mmol·L^(-1)]高于对照组[(3.13±0.18) mmol·L^(-1)](t=13.527,χ^(2)=9.289,t=15.521,均P<0.05)。结论 门冬胰岛素联合地特胰岛素治疗儿童糖尿病能有效提高临床疗效,改善糖脂代谢水平,且安全性较高。

Objective To investigate the therapeutic efficacy of levemir combined with novorapid in the treatment of pediatric diabetes mellitus.Methods One hundred and thirty-eight children with pediatric type 1 diabetes mellitus admitted to Tianjin Children's Hospital(Children's Hospital of Tianjin University)from November 2022 to August 2023 were selected as the subjects and divided into two groups using the random number table method,with 69 in each.The children in the control group received isophane protamine biosynthetic human insulin injection,while those in the study group were given insulin aspart combined with insulin detemir.Then the therapeutic efficacy,blood glucose,blood lipid and the occurrence of hypoglycaemia were compared between the two groups.Results After treatment,the study group reported a higher therapeutic efficacy rate as compared with the control(91.30%vs 72.47%,χ^(2)=8.256,P<0.05).A reduction was found in glycosylated haemoglobin,fasting blood glucose and 2-hour postprandial blood glucose in all patients after treatment,and the reduction was more notable in the observation group than in the control((6.03±1.20)%vs(7.67±1.49)%,(6.14±1.32)mmol·L^(-1) vs(7.34±2.06)mmol·L^(-1),(7.55±2.01)mmol·L^(-1) vs(9.36±3.15)mmol·L^(-1),t=7.121,4.074,4.024,all P<0.05).An increase in high-density lipoprotein cholesterol and a decrease in low-density lipoprotein cholesterol,total cholesterol and triglycerides were detected in all patients after treatment,and both improvements were more notable in the observation group than in the control((1.72±0.63)mmol·L^(-1) vs(1.38±0.47)mmol·L^(-1),(4.31±0.65)mmol·L^(-1) vs(5.26±0.74)mmol·L^(-1),(1.59±0.85)mmol·L^(-1) vs(2.25±0.94)mmol·L^(-1),(1.44±0.47)mmol·L^(-1) vs(2.06±0.54)mmol·L^(-1),t=3.593,8.012,4.326,7.194,all P<0.05).After treatment,the frequency and number of hypoglycemia incidence were(0.75±0.17)times/week and 8.70%in the observation group,which were lower than those of(1.19±0.21)times/week and 28.99%in the control(t=13.527,χ^(2)=9.289,all P<0.05).The level of hypoglycemia was(3.58±0.16)mmol·L^(-1) in the observation group,which was higher than that of(3.13±0.18)mmol·L^(-1) in the control(t=15.521,P<0.05).Conclusion Application of insulin aspart combined with insulin detemir in the treatment of pediatric diabetes has good efficacy and safety profile,which can effectively improve the glycolipid metabolism.