2022 年第 12 期 第 17 卷

维格列汀联合门冬胰岛素50注射液对初诊2型糖尿病患者氧化应激及胰岛功能的影响

Effects of vildagliptin combined with insulin aspart 50 injection on oxidative stress and islet function in newly diagnosed patients with type 2 diabetes mellitus

作者：王慧 王小翠 张瑞 童强

英文作者：Wang Hui Wang Xiaocui Zhang Rui Tong Qiang

单位：陆军军医大学第二附属医院内分泌科，重庆400037

英文单位：Department of Endocrinology the Second Affiliated Hospital of Army Medical University Chongqing 400037 China

关键词：2型糖尿病；维格列汀；门冬胰岛素50注射液；氧化应激；胰岛功能

英文关键词：Type2diabetesmellitus;Vildagliptin;Insulinaspart50injection;Oxidativestress;Isletfunction

• 摘要：

• 目的  观察维格列汀联合门冬胰岛素50注射液对初诊2型糖尿病患者氧化应激及胰岛功能的影响。方法  选取陆军军医大学第二附属医院内分泌科2017年2月至2019年6月门诊或住院治疗的90例初诊2型糖尿病患者作为研究对象。根据随机数字表法分为对照组和观察组，每组45例。对照组在常规治疗基础上早餐及晚餐前皮下注射门冬胰岛素50注射液治疗；观察组在对照组基础上加用维格列汀片口服治疗，观察时间均为6个月。比较2组患者血糖水平、血糖波动、氧化应激及胰岛功能指标。比较2组治疗6个月后每日胰岛素使用剂量及观察期间的低血糖发生情况。结果  治疗后观察组空腹血糖、餐后2 h血糖、糖化血红蛋白、24 h平均血糖、日平均血糖波动幅度、餐后血糖漂移幅度及最大血糖波动幅度均低于/小于对照组，差异均有统计学意义(均P<0.05)。治疗后2组活性氧、丙二醛水平均低于治疗前，且观察组低于对照组，超氧化物歧化酶、过氧化氢酶、谷胱甘肽过氧化物酶水平均高于治疗前，且观察组高于对照组，差异均有统计学意义(均P<0.05)。治疗后观察组空腹胰岛素、稳态模型胰岛β细胞功能指数均高于对照组，稳态模型胰岛素抵抗指数低于对照组［（11.9±1.4）mIU/L比（8.4±1.9）mIU/L、（192±176）比（69±61）、（2.5±0.7）比（2.9±0.5）］，差异均有统计学意义(均P<0.05)。治疗6个月后，观察组每日胰岛素使用剂量少于对照组(P<0.001)。观察期2组低血糖发生率差异无统计学意义（P=0.083）。结论  维格列汀联合门冬胰岛素50注射液不但可有效控制初诊2型糖尿病患者血糖水平及血糖波动，还可明显改善患者氧化应激及胰岛功能。

• Objective  To observe the effect of vildagliptin combined with insulin aspart 50 injection on oxidative stress and islet function in newly diagnosed patients with type 2 diabetes mellitus. Methods  From February 2017 to June 2019, 90 patients with newly diagnosed type 2 diabetes mellitus were selected from Department of Endocrinology, the Second Affiliated Hospital of Army Medical University. According to the random number table method, they were divided into the control group and the observation group, with 45 cases in each group. The control group was treated with subcutaneous injection of insulin aspart 50 injection before breakfast and dinner on the basis of routine treatment; on the basis of the control group, the observation group was treated with vildagliptin tablets orally. Both groups were observed for 6 months. The blood glucose, blood glucose excursions, oxidative stress and islet function indexes were compared between the two groups. The daily insulin dosage 6 months after treatment and the occurrence of hypoglycemia during the observation period were compared between the two groups. Results  After treatment, the fasting blood glucose, 2 h postprandial blood glucose, glycosylated hemoglobin, 24 h average blood glucose, daily mean amplitude of glycemic excursions, amplitude of postprandial blood glucose drift and maximum amplitude of glycemic excursions in the observation group were lower/less than those in the control group (all P<0.05). Levels of reactive oxygen species and malondialdehyde in the two groups after treatment were lower than those before treatment, and the levels in the observation group were lower than those in the control group; levels of superoxide dismutase, catalase and glutathione peroxidase in the two groups were higher than those before treatment, and the levels in the observation group were higher than those in the control group (all P<0.05). The level of fasting insulin and the homeostasis model assessment islet β cell function index in the observation group after treatment were higher than those in the control group, and the homeostasis model assessment insulin resistance index was lower than that in the control group［(11.9±1.4)mIU/L vs (8.4±1.9)mIU/L, (192±176) vs (69±61), (2.5±0.7) vs (2.9±0.5)］(all P<0.05). After 6 months of treatment, the daily insulin dosage in the observation group was less than that in the control group (P<0.001). There was no significant difference in the incidence of hypoglycemia between the two groups during the observation period(P=0.083). Conclusion  The treatment of vildagliptin combined with insulin aspart 50 injection can not only control the blood glucose level and blood glucose excursions in newly diagnosed patients with type 2 diabetes mellitus, but also significantly improve the oxidative stress and islet function.