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目的观察西格列汀片联合地特胰岛素注射液治疗老年2型糖尿病(T2DM)的临床疗效及安全性。方法将120例老年T2DM患者随机分为对照组60例和试验组60例。2组患者均予以地特胰岛素,每晚1次,初始剂量0.2U·kg~(-1),皮下注射。对照组予以瑞格列奈0.5~2.0 mg,tid,口服;试验组予以西格列汀100 mg,qd,口服。2组患者均治疗12周。比较2组患者的临床疗效、血糖水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为95.00%(57/60例)和76.67%(46/60例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组餐后2 h血糖(2 h PG)分别为(8.20±1.14)和(9.87±1.64)mmol·L~(-1),胰岛素用量分别为(20.81±6.32)和(39.86±5.40)U·d~(-1),高血糖时间比(2 h PG>11.1 mmol·L~(-1))分别为(2.26±1.85)%和(15.93±10.76)%,低血糖时间比分别为(2.64±1.99)%和(3.60±2.84)%,血糖波动系数分别为1.50±0.26和2.47±0.39,差异均有统计学意义(均P<0.05)。2组患者的药物不良反应均为低血糖,试验组和对照组的低血糖发生率分别为1.67%和10.00%,差异有统计学意义(P<0.05)。结论西格列汀片联合地特胰岛素注射液能够有效地控制老年T2DM患者血糖水平,减少血糖波动,降低低血糖发生率。
Objective To observe the clinical efficacy and safety of sitagliptin tablet and insulin detemir injection in the treatment of senile type 2 diabetes mellitus (T2DM). Methods A total of 120 elderly patients with T2DM were randomly divided into control group (60 cases) and experimental group (60 cases). Patients in both groups were treated with insulin detemir every night, the initial dose of 0.2U · kg ~ (-1), subcutaneous injection. The control group was given repaglinide 0.5 ~ 2.0 mg, tid, orally; the test group was given sitagliptin 100 mg, qd, orally. Two groups of patients were treated for 12 weeks. The clinical efficacy, blood glucose level and adverse drug reactions in two groups were compared. Results After treatment, the total effective rate was 95.00% (57/60) and 76.67% (46/60) respectively in the experimental group and the control group, the difference was statistically significant (P <0.05). After treatment, the 2 h postprandial plasma glucose (2 h PG) of test group and control group were (8.20 ± 1.14) and (9.87 ± 1.64) mmol·L -1 respectively, and the dosage of insulin was (20.81 ± 6.32) and (39.86 ± 5.40) U · d ~ (-1) and hyperglycemia time (2.26 ± 1.85)% and (15.93 ± 10.76)% respectively for 2 h PG> 11.1 mmol·L -1 The blood glucose time was (2.64 ± 1.99)% and (3.60 ± 2.84)% respectively. The blood glucose fluctuation coefficients were 1.50 ± 0.26 and 2.47 ± 0.39, respectively (all P <0.05). The adverse drug reactions of the two groups were all hypoglycemia. The incidences of hypoglycemia in the experimental and control groups were 1.67% and 10.00%, respectively, with statistical significance (P <0.05). Conclusion Sitagliptin combined with insulin injection can effectively control the elderly patients with T2DM blood glucose levels, reduce blood glucose fluctuations and reduce the incidence of hypoglycemia.