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目的比较初诊2型糖尿病(T2DM)患者服用消渴丸、瑞格列奈治疗前后空腹、30、120 min真胰岛素量及其与放免胰岛素比值的变化特征。方法初诊T2DM患者90例,随机分为消渴丸组44例,瑞格列奈组46例。留取治疗前后空腹、30 min和120 min静脉血,采用葡萄糖氧化酶法测定血糖,酶联免疫吸附法测定真胰岛素(TI),放射免疫法测定放射免疫性胰岛素(IRI),并计算各时刻TI/IRI。结果消渴丸组治疗后,30 min时TI/IRI较治疗前有所增加,但差异无统计学意义(P>0.05),高峰在120 min时,TI/IRI与治疗前相比有明显增加(0.60±0.13 vs 0.53±0.14,P<0.05);瑞格列奈组治疗后,TI/IRI的高峰在30 min时与治疗前相比有明显增加(0.63±0.08 vs 0.44±0.17,P<0.05)。结论初诊T2DM患者经消渴丸治疗后,可显著改善120 min时胰岛素分泌的质与量,与瑞格列奈组治疗后早期相胰岛素分泌的质与量存在一定的差异。
Objective To compare the changes of real insulin at 30,120 min and the ratio of insulin to insulin before and after fasting, before and after repaglinide treatment in patients with newly diagnosed type 2 diabetes mellitus (T2DM). Methods A total of 90 newly diagnosed T2DM patients were randomly divided into Xiaokewan group (44 cases) and repaglinide group (46 cases). Fasting blood samples were collected before and after treatment for 30 min and 120 min respectively. Glucose oxidase method was used to measure blood glucose. Real insulin (TI) was measured by ELISA. Radioimmunoassay was performed to determine radioimmunity insulin (IRI) TI / IRI. Results TI / IRI increased at 30 min after treatment in Xiaoke Pill group, but the difference was not statistically significant (P> 0.05). At the peak of 120 min, TI / IRI increased significantly compared with before treatment (0.60 ± 0.13 vs 0.53 ± 0.14, P <0.05). After repaglinide treatment, the peak of TI / IRI increased significantly at 30 min (0.63 ± 0.08 vs 0.44 ± 0.17, P < 0.05). Conclusions Newly diagnosed T2DM patients treated with Xiaoke Pill can significantly improve the quality and quantity of insulin secretion at 120 min, which is different from the quality and quantity of early phase insulin secretion after repaglinide treatment.