张晓云

[摘要] 目的 探讨西格列汀联合大剂量胰岛素对2型糖尿病患者血糖及血脂的影响。 方法 将94例2型糖尿病患者随机分成观察组和对照组，每组47例。对照组患者采用大剂量胰岛素进行治疗，观察组在此基础上给予西格列汀进行治疗。对比两组患者的血糖、血脂水平及低血糖事件、不良反应发生率。 结果 治疗后，观察组患者的空腹血糖、餐后2小时血糖、糖化血红蛋白、甘油三酯、总胆固醇、低密度脂蛋白水平及低血糖事件发生率均显著低于对照组（P<0.05）；观察组患者的高密度脂蛋白水平明显高于对照组（P<0.05）；两组患者的不良反应发生率差异无统计学意义（P>0.05）。结论 西格列汀联合大剂量胰岛素能够有效改善2型糖尿病患者的血糖和血脂水平，预防低血糖事件，是安全而理想的治疗方式。

[关键词] 西格列汀；胰岛素；2型糖尿病；血糖；血脂

[中图分类号] R587 [文献标识码] A [文章编号] 1672-4062（2016）03（b）-0003-03

[Abstract] Objective To investigate the effects of sitagliptin combined with high dose of insulin on the blood glucose and blood fat levels of patients with type 2 diabetes. Methods 94 patients with type 2 diabetes were randomly divided into the observation group and control group， with 47 cases in each. The control group patients were treated with high dose of insulin， the observation group were treated with sitagliptin and high dose of insulin. The blood glucose level， the blood fat level， the hypoglycemia event rate and the incidence of adverse reactions were compared between the two groups. Results After the treatment， the fasting blood glucose level， the 2-hour postprandial blood glucose level， the glycosylated hemoglobin level， the triglyceride level， the total cholesterol level， the low-density lipoprotein level and the hypoglycemia event rate in the observation group were notably lower than those in the control group （P<0.05）. The high-density lipoprotein level in the observation group was clearly higher than that in the control group（P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P>0.05）. Conclusion The sitagliptin combined with high dose of insulin can efficaciously improve the blood glucose level and the blood fat level， prevent the hypoglycemia event. It is a safe and ideal treatment.

[Key words] Sitagliptin； Insulin； Type 2 diabetes； Blood glucose； Blood fat

2型糖尿病是一种以持续性胰岛素抵抗和β细胞功能衰退为主要特征的退行性疾病，近年来发病率在我国呈现明显的增加趋势[1]。随着病程的延长，2型糖尿病患者胰岛细胞功能衰退也更为严重，血糖控制效果也不尽人意，部分患者经大剂量胰岛素治疗后临床疗效仍不理想。该研究对2型糖尿病患者采用西格列汀联合大剂量胰岛素方案进行治疗，有效地改善了患者的血糖和血脂水平，现将有关情况进行总结。

1 资料与方法

1.1 一般资料

选取2014年9月—2015年9月收治的94例2型糖尿病患者，按随机数表法分成观察组和对照组，每组各47例。观察组中男性25例，女性22例；年龄42～71岁，平均（59.85±6.88）岁；病程3～12年，平均（7.52±1.03）年；BMI16～25 kg/㎡，平均（22.17±2.89） kg/㎡。……