沓世泽 张武健 黄东柱 　黄家

【摘要】 目的：研究及觀察达格列净联合胰岛素对2型糖尿病患者氧化损伤及血糖波动的影响。方法：将2019年1月-2021年2月的80例2型糖尿病患者按照随机数字表法分为胰岛素组（对照组）和达格列净联合胰岛素组（观察组），每组40例。比较两组治疗后的血糖达标率、治疗前后的血糖水平、糖化血红蛋白水平、氧化损伤指标（血清SOD、MDA、LPO及TAC）及血糖波动指标（LAGE、PPGE、SDBG及MODD）。结果：观察组治疗1、2、4周血糖达标率均显著高于对照组，差异均有统计学意义（P<0.05）。治疗前，两组血糖水平、糖化血红蛋白水平、氧化损伤指标及血糖波动指标比较，差异均无统计学意义（P>0.05）;治疗2、4周，观察组血糖水平、糖化血红蛋白水平、血糖波动指标及血清MDA、LPO均显著低于对照组，血清SOD、TAC均显著高于对照组，差异均有统计学意义（P<0.05）。结论：达格列净联合胰岛素在2型糖尿病患者中的应用效果较好，且对氧化损伤及血糖波动的影响更为积极，因此在2型糖尿病患者中的应用价值较高。

【关键词】 达格列净 胰岛素 2型糖尿病 氧化损伤 血糖波动

Study on Influence of Dapagliflozin Combined with Insulin for Oxidative Damage and Blood Glucose Fluctuation of Patients with Type 2 Diabetes Mellitus/DA Shize， ZHANG Wujian， HUANG Dongzhu， HUANG Jiafeng. //Medical Innovation of China， 2021， 18（34）： 0-014

[Abstract] Objective： To study and observe the influence of Dapagliflozin combined with Insulin for oxidative damage and blood glucose fluctuation of patients with type 2 diabetes mellitus. Method： A total of 80 patients with type 2 diabetes mellitus from January 2019 to February 2021 were divided into Insulin group （the control group） and Dapagliflozin combined with Insulin group （the observation group） according to the random number table method， 40 cases in each group. Then the blood glucose standard rates after treatment， blood glucose level， glycosylated hemoglobin level， oxidative damage indexes （serum SOD， MDA， LPO and TAC） and blood glucose fluctuation indexes （LAGE， PPGE， SDBG and MODD） before and after treatment of two groups were compared. Result： The blood glucose standard rates of the observation group at 1， 2 and 4 weeks of treatment were significantly higher than those of the control group， there were statistically significant differences （P<0.05）. Before treatment， the blood glucose level， glycosylated hemoglobin level， oxidative damage indexes and blood glucose fluctuation indexes of two groups were compared， there were no statistically significant differences （P>0.05）. At 2 and 4 weeks of treatment， the blood glucose level， glycosylated hemoglobin level， blood glucose fluctuation indexes and serum MDA， LPO of the observation group were all significantly lower than those of the control group， the serum SOD and TAC were significantly higher than those of the control group， there were statistically significant differences （P<0.05）. Conclusion： The application effect of Dapagliflozin combined with Insulin for patients with type 2 diabetes mellitus is better， and its influence for oxidative damage and blood glucose fluctuation is more active， so its application value in patients with type 2 diabetes mellitus is higher.

[Key words] Dapagliflozin Insulin Type 2 diabetes mellitus Oxidative damage Blood glucose fluctuation First-author’s address： Luoding People’s Hospital， Luoding 527200， China

doi：10.3969/j.issn.1674-4985.2021.34.003

2型糖尿病在我国具有极高的发病率，而其相关并发症的发生是临床重点防控方面。与2型糖尿病并发症发生及防控相关的研究显示，血糖波动是与糖尿病肾病、视网膜病变及其他并发症发生密切相关的方面，因此对于血糖波动幅度的控制是糖尿病并发症控制的重点方面之一[1-3]。另外，抗氧化能力也是在本类患者中受损突出的方面，因此氧化损伤情况在本类患者中表现突出，而这也是与多系统器官并发症发生密切相关的方面[4-5]。……