2型肥胖糖尿病患者应用胰岛素联合SGLT2抑制剂疗效和安全性研究.docx

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1、2型肥胖糖尿病患者应用胰岛素联合SGLT2抑制剂疗效和安全性研究魏香兰表1两组患者临床疗效比较()组别ZI显效有效无效总有效联合组6035(58.33)21(35.00)4(6.67)56(93.33)单一组6019(31.67)24(40.00)17(28.33)43(71.67)X2 值9.755P 值0.008表2两组患者肥胖指标比较(a一)纲别nBMI(kg/nr)XC(cm)治疗前治疗后值，值治疗前治疗后Pitl联合组6029.481.3923.161.2513.4120.000113.25 10.5387.4573554.7520.048次一组6029.511.427.291.36

2、4.0650.002111.7810.2l(X).578.929.541().032，值0.114173190.77412.814Ptii0.0980.0060.0840.012表3两组患者血糖水平比较(K5)组别291治疗前治疗后，值 ，值治疗前治疗后，值值治疗前治疗后，值 PtL联合组6010.393.155.421.7310.5470.02816.284.89 7.631.8218357 0.0709.822345.251.679.6980.000小一组6010.073.078.161.943.5000.04615.744.64 10.253.1110.053 0.0059.91 2.5

3、77.271.854.8340.015，值0.5648.1650.62143810.2016.278，值0.7540.0240.2550.0750.9870.010表4两组患者安全性情况比较卬)组别n肾功能下降低血糖恶心呕吐泌尿4死道感染总发生联合组600!(1.67)2(3.33)03(5.00)单一组605(833)4(6.67)7(11.67)2(3.33)18(30.00)rtfi12.987。值0.002Summary目的 觐察胰岛素联合SGLT2抑制剂对2型肥胖糖尿病患者疗效及安全性的影响。方法纳入2019年6月至2020年6月我院收治的2型肥胖糖尿病患者共120例，将所有研究对象

4、随机分为联合组与单一组，每组各60例。单一组给予常规胰岛素治疗，联合组在单一组基础上给予SGLT2抑制剂，观察两组疗效、肥胖指标、血糖水平及安全性情况。结果联合组临床总有效率为93. 33%,高于单一组的71.67%,差异有统计学意义(P0. 05) o组内比较，两组.BMI、WC指数、FBG、2 hPG、HbAlc水平均低于治疗前(P0. 05)；组间比较，联合组BMI、WC指数、血糖各指标水平均低于单一组(P0.05) o联合组不良反应总发生率为5.00%,低于单一组的30. 00%,差异有统计学意义(P0.05) o结论 胰岛素联合SGLT2抑制剂治疗2型肥胖糖尿病的疗效显著，可降低患者

5、体质量指数、腰围及血糖水平，且安全性较高，值得临床广泛推广并应用。Key 2型肥胖糖尿病；胰岛素；SGLT2抑制剂；安全性R587. 1口 1673-9701 (2021) 30-0111-04Abstract Objective To observe the effect of insulin combined withSGLT2 inhibitor on the efficacy and safety in treating obese patientswith type 2 diabetes mellitus. Methods A total of 120 obese patientsw

6、ith type 2 diabetes mellitus who were admitted to our hospital fromJune 2019 to June 2020 were enrolled. All subjects were randomlydivided into the combination group and the single-therapy group, with60 cases in each group. The single-therapy group was givenconventional insulin treatment, while the

7、combination group wasgiven SGLT2 inhibitors on the basis of the same treatment as thesingle-therapy group. The efficacy, obesity indicators, bloodglucose levels and safety of the two groups were observed. ResultsThe total effective rate of clinical treatment in the combinationgroup was 93.33%, wihch

8、 was higher than that of 71. 67% in thesingle-therapy group, with statistically significant difference(P0. 05) . According to the comparison within the groups, the BMI,WC index, FBG, 2 hPG and HbAlc levels of the two groups aftertreatment were lower than those before treatment (P0. 05).According to

9、the comparison between groups, the levels of BML WCindex, and blood glucose in the combination group were lower thanthose in the single-therapy group (P0, 05) . The total incidence ofadverse reactions in the combination group was 5. 00%, which was lowerthan that of 30. 00% in the single-therapy grou

10、p, with statisticallysignificant difference (P0.05),具有可比性。该研究经我院医学伦理委员会审批通过后执行。1. 2纳入标准符合中国2型糖尿病防治指南(2017年版)3中肥胖及糖尿病的相关诊断标准;年龄40岁且80岁；体质量指数超过25 kg/m2,女性腰围超过80 cm,男性腰围超过90 cm者;经胰岛素治疗后血糖仍未有效控制者;空腹血糖(Fasting blood-glucose, FBG)超过 7.0 mmol/L,餐后 2 h 血糖(2hour postprandial blood glucose, 2 hPG)超过 11. 1 mmo

11、l/L,糖化血红蛋白(Glycated hemoglobin, HbAlc)超过7%；遵医嘱用药且按时回院复查者;所有患者及其家属知情本研究并签署知情同意书。1.3排除标准成人隐匿性免疫性糖尿病及1型糖尿病者;糖尿病急性并发症者;急慢性代谢性酸中毒、急性感染者;严重营养不良、继发性或家族性肥胖者;恶性肿瘤、心、肾、肝功能异常者;临床资料不全、治疗依从性差者。1. 4方法所有患者入院后均由专门的内分泌专科医师为其普及糖尿病健康知识，并制订合理的饮食及运动方案。单一组在此基础上仅给予胰岛素治疗，并根据其血糖水平变化情况适当调整胰岛素用量。联合组在单一组的基础上给予达格列净片(阿斯利康制药有限公司，国药准字J20170040,规格：10啕义10片义3