精蛋白重组人胰岛素混合注射液40/60治疗老年2型糖尿病的疗效及对患者预后的影响

Efficacy of Protamine Recombinant Human Insulin Mix 40/60 in Treating Elderly Patients with Type 2 Diabetes and Its Impact on Prognosis

肖瑶 ¹潘尹红 ¹马利红 ¹秦杨¹

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作者信息

1. 西部战区总医院全科医学科,四川成都 610000
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摘要

目的:探讨精蛋白重组人胰岛素混合注射液 40/60(简称甘舒霖 40/60)治疗老年 2 型糖尿病(T2DM)的疗效及对患者预后的影响.方法:采用简单随机分组法将西部战区总医院 2022 年 12月至2023 年12 月收治的106 例T2DM患者分为对照组(n=53)和治疗组(n=53).对照组予常规二联降糖方案治疗(二甲双胍+达格列净),治疗组予甘舒霖 40/60 皮下注射治疗.12 周后评价疗效及安全性,测定两组治疗前、后血糖指标、体重指数(BMI)、胰岛 β 细胞功能指标及血清单核细胞趋化因子(MCP-1)、超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6)水平差异,并统计随访6 个月预后.结果:治疗组治疗总有效率为90.57%,较对照组的71.70%更高(P<0.05).治疗后,与对照组相比,治疗组空腹血糖(FPG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbAlc)、胰岛素抵抗指数(HOMA-IR)及血清MCP-1、hs-CRP、IL-6 水平更低,胰岛β细胞功能指数(HOMA-β)更高(P<0.05).治疗组(3.77%)、对照组(7.55%)总不良反应发生率比较差异无统计学意义(P>0.05);两组随访6 个月微血管并发症发生率差异无统计学意义(P>0.05).结论:采用甘舒霖 40/60 皮下注射治疗老年 T2DM 安全有效,不仅能降低患者血糖水平,促进胰岛β细胞功能恢复,减轻炎症反应,但并未改善患者短期预后.

Abstract

Objective:To explore the efficacy of protamine recombinant human insulin mix 40/60(re-ferred to as Gansulin 40/60)in treating elderly patients with type 2 diabetes(T2DM)and its impact on prog-nosis.Methods:A total of 106 elderly T2DM patients admitted to Western Theater General Hospital between December 2022 and December 2023 were randomly divided into a control group(n=53)and a treatment group(n=53).The control group received standard dual antidiabetic therapy(metformin+dapagliflozin),while the treatment group was given Gansulin 40/60 subcutaneous injections.After 12 weeks,efficacy and safety were evaluated,and pre-and post-treatment glycemic indicators,body mass index(BMI),β-cell function,and serum levels of monocyte chemoattractant protein-1(MCP-1),high-sensitivity C-reactive protein(hs-CRP),and interleukin-6(IL-6)were measured.The prognosis of both groups was tracked for 6 months.Results:The overall effective rate in the treatment group was 90.57%,higher than that in the con-trol group(71.70%)(P<0.05).After treatment,the treatment group showed lower fasting plasma glucose(FPG),2-hour postprandial glucose(2hPG),glycosylated hemoglobin(HbA1c),homeostasis model as-sessment of insulin resistance(HOMA-IR),and serum MCP-1,hs-CRP,and IL-6 levels,and higher β-cell function index(HOMA-β)compared to the control group(P<0.05).The overall incidence of adverse reactions in the treatment group(3.77%)was not significantly different from that in the control group(7.55%)(P>0.05).There was no significant difference in the incidence of microvascular complications between the two groups over the 6-month follow-up period(P>0.05).Conclusion:Subcutaneous injection of Gansu-lin 40/60 in elderly T2DM patients is safe and effective,lowering blood glucose levels,promoting β-cell function recovery,and reducing inflammation,though it does not significantly improve short-term prognosis.

关键词

2型糖尿病/老年人/精蛋白重组人胰岛素混合注射液/血糖/糖化血红蛋白/预后

Key words

Type 2 diabetes mellitus/Elderly/Protamine recombinant human insulin mixed in-jection 40/60(Ganshulin 40/60)/Blood glucose/Glycated hemoglobin/Prognosis

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基金项目

四川省卫生健康委员会科研课题(川干研2021-1302)

出版年

2024

河北医学

河北省医学会

河北医学

CSTPCD

影响因子：1.915

ISSN：1006-6233

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