冯文静++张玉好++张丽娜

DOI：10.16658/j.cnki.1672-4062.2017.12.005

[摘要] 目的 研究甘精胰島素联合口服降糖药治疗磺脲类继发性失效的2型糖尿病的临床疗效。方法 选择该院2015年3月—2016年9月患有磺脲类继发性失效的2型糖尿病的临床病例80例进行分析，随机分为观察组和对照组，每组40例。对照组采取常规的治疗，观察组采取甘精胰岛素联合口服降糖药的方式治疗，所有患者在治疗前后12周测定空腹血糖（FBG）、餐后2 h的血糖值（2 hBG）和糖化血红蛋白值（HbA1c），观察比较两组结果。结果 两组患者治疗3个月后，空腹血糖（FBG）、餐后2 h的血糖值（2 hBG）和糖化血红蛋白值（HbA1c）较治疗前明显降低，对于空腹血糖值而言，观察组明显高于对照组，差异有统计学意义（P<0.05）；观察组治疗期间出现低血糖的例数明显低于对照组，差异有统计学意义（P<0.05）。 结论 采取甘精胰岛素联合口服降糖药治疗磺脲类继发性失效的2型糖尿病，能有效的控制血糖，低血糖发生率低，治疗安全性高，值得在临床上广泛使用。

[关键词] 2型糖尿病；甘精胰岛素；继发性失效

[中图分类号] R587.1 [文献标识码] A [文章编号] 1672-4062（2017）06（b）-0005-02

Clinical Observation on Insulin Glargine and Oral Administration of Hypoglycemic in Treatment of Secondary Failure of Sulfonylurea in Type 2 Diabetes Mellitus

FENG Wen-jing1， ZHANG Yu-hao2， ZHANG Li-na3

1.Veteran Cadre Department， 107th Hospital of PLA Affiliated to Binzhou Medical University， Yantai， Shandong Province， 264002 China；2.Endocrinology Department， 107th Hospital of PLA Affiliated to Binzhou Medical University， Yantai， Shandong Province， 264002 China

[Abstract] Objective To research the clinical curative effect of insulin glargine and oral administration of hypoglycemic in treatment of Secondary failure of sulfonylurea in type 2 diabetes mellitus. Methods 80 cases of patients with secondary failure of sulfonylurea in type 2 diabetes mellitus in our hospital from March 2015 to September 2016 were selected and randomly divided into two groups with 40 cases in each， the control group adopted the routine treatment， while the observation group adopted the insulin glargine and oral administration of hypoglycemic， and the FBG， 2 hBG and HbA1c were measured in 12 weeks before and after treatment， and the results were observed and compared. Results After three-month treatment， the FBG， 2 hBG and HbA1c obviously decreased compared with those before treatment， and the FBG in the observation group was obviously higher than that in the control group， and the difference was statistically significant（P<0.05）； the hypoglycemia case in the observation group was obviously fewer than that in the control group， and the difference was statistically significant（P<0.05）. Conclusion The insulin glargine and oral administration of hypoglycemic in treatment of secondary failure of sulfonylurea in type 2 diabetes mellitus can effectively control the blood glucose and reduce the incidence rate of hypoglycemia with high treatment safety， which is worth wide application in clinic.endprint

[Key words] Type 2 diabetes； Insulin glargine； Secondary failure

磺脲类药物继发性失效（SFS）是2型糖尿病患者治疗中出现的常见问题，其发生率约为20%～30%，年增长率在5%～10%，连续5年之后可高达40%～50%，甘精胰岛素是一种长效胰岛素，在中性pH液中溶解度低的人胰岛素类似物，在酸性介质中完全溶解。该药对患者造成低血糖的几率很低，有平稳降血糖的优势[1]。对SFS患者进行胰岛素强化治疗是关键，为了能有效恢复部分胰岛B细胞，该文2015年3月—2016年9月采用对比方式研究了甘精胰岛素联合口服降糖药治疗磺脲类继发性失效的2型糖尿病的临床疗效，现报道如下。

1 资料与方法

1.1 一般资料

选取该院从2015年3月—2016年9月期间收治的磺脲类继发性失效的2型糖尿病患者病例80例作为研究对象。将80例患者随机分为观察组和对照组，每组40例。……