精蛋白生物合成人胰岛素注射液（预混30R）强化治疗初发2型糖尿病的临床研究-中国药房

精蛋白生物合成人胰岛素注射液（预混30R）强化治疗初发2型糖尿病的临床研究

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篇名：	精蛋白生物合成人胰岛素注射液（预混30R）强化治疗初发2型糖尿病的临床研究
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摘要：	目的：探讨精蛋白生物合成人胰岛素注射液（预混30R）（以下简称“诺和灵30R”）强化治疗对初发2型糖尿病患者血糖、糖化血红蛋白（HbA1c）及胰岛B细胞功能等的影响。方法：将68例2型糖尿病初发患者根据随机数字表法分为观察组和对照组，各34例。对照组患者口服阿卡波糖+格列美脲；观察组患者皮下注射诺和灵30R，根据血糖水平调整胰岛素注射剂量及次数。两组患者的血糖控制目标均为空腹血糖（FBG）3.9～7.2 mmol/L、餐后2 h血糖（2 hPG）7.8～10.0 mmol/L。比较两组患者的FBG、2 hPG、HbA1c、血糖达标时间、体质量指数（BMI）和胰岛B细胞功能。结果：治疗前，两组患者的FBG、2 hPG、HbA1c及BMI比较，差异均无统计学意义（P＞0.05）；治疗后，两组患者的FBG、2 hPG和HbA1c均较治疗前明显降低，且观察组明显低于对照组，血糖达标时间亦明显短于对照组，差异均有统计学意义（P＜0.05）；两组患者的BMI在治疗前后比较差异无统计学意义（P＞0.05）。治疗前，两组患者的胰岛素抵抗指数（HOMA-IR）、胰岛素分泌指数（HOMA-B）、糖负荷后30 min胰岛素净增值与葡萄糖净增值的比值（I30/G30）比较，差异均无统计学意义（P＞0.05）；治疗后，两组患者的HOMA-IR较治疗前明显降低，HOMA-B和I30/G30较治疗前明显升高，且观察组患者的上述指标明显优于对照组，差异均有统计学意义（P＜0.05）。两组患者均未见明显不良反应发生。结论：诺和灵30R强化治疗能够更为有效地降低初发2型糖尿病患者血糖和HbA1c水平，缩短血糖达标时间，改善胰岛B细胞功能，且安全性较好。
ABSTRACT：	OBJECTIVE： To investigate the effects of intensive treatment of Isophane protamine biosynthetic human insulin injection （premix 30R， called “Novolin 30R” for short） on blood glucose， HbA1c and islet B cell function of patients with primary type 2 diabetes. METHODS： 68 patients with primary type 2 diabetes were divided into observation group and control group by random number table method， with 34 cases in each group. Control group received acarbose+glimepiride orally； observation group received Novolin 30R subcutaneously， and the dose and times of injection were adjusted according to blood glucose level. The target fasting blood glucose （FBG） and 2 h postprandial blood glucose （2 hPG） were 3.9-7.2 mmol/L and 7.8-10.0 mmol/L. FBG， 2 hPG， HbA1c， the time of blood glucose reaching the standard， BMI and islet B cell function were compared between 2 groups. RESULTS： FBG， 2 hPG， HbA1c and BMI of 2 groups had no statistical significance before treatment （P＞0.05）； compared to before treatment， FBG， 2 hPG and HbA1c of 2 groups were decreased significantly after treatment， and observation group were significantly lower than those of control group； the time of blood glucose reaching the standard was significantly shorter than control group， with statistical significance （P＜0.05）. There was no statistical significance in BMI between 2 groups before and after treatment （P＞0.05）. Before treatment， HOMA-IR， HOMA-B and I30/G30 of 2 groups had no statistical significance （P＞0.05）； compared to before treatment， HOMA-IR of 2 groups were decreased significantly， while HOMA-B and I30/G30 were increased significantly after treatment； the indexes of observation group was significantly better than that of control group with statistical significance （P＜0.05）. No obvious ADR was found in 2 groups. CONCLUSIONS： Intensive treatment of Novolin 30R can effectively reduce blood glucose and HbA1c levels of patients with primary type 2 diabetes， shorten the time of blood glucose reaching standard and improve islet B cell function with good safety.
期刊：	2016年第27卷第32期
作者：	王郡，周慧敏，董斌，窦婵婵，陈志花，郭艺璇，吕晓静
AUTHORS：	WANG Jun，ZHOU Huimin，DONG Bin，DOU Chanchan，CHEN Zhihua，GUO Yixuan，LYU Xiaojing
关键字：	精蛋白生物合成人胰岛素注射液（预混30R）；初发2型糖尿病；强化治疗；血糖；糖化血红蛋白；胰岛B细胞
KEYWORDS：	Isophane protamine biosynthetic human insulin injection （premix 30R）； Primary type 2 diabetes； Intensive treatment； Blood glucose； Glycated hemoglobin； Islet B cell
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