诺和锐短期强化治疗肝功能失代偿期肝源性糖尿病的临床疗效及安全性.docVIP

诺和锐短期强化治疗肝功能失代偿期肝源性糖尿病的临床疗效及安全性 　　[摘要] 目的 探讨诺和锐（门冬胰岛素注射液）短期强化治疗肝功能失代偿期肝源性糖尿病的临床疗效及安全性。方法 进行为期2周的随机、开放性比较研究。将100例患者随机分为治疗组和对照组各50例。两组均采用内科常规治疗，对照组给予诺和灵30R每日早、晚餐前皮下注射方案，治疗组给予诺和锐每日早、中、晚餐前三次皮下注射强化方案。测定短期强化治疗前后两组患者空腹血糖（FBG）、餐后2 h血糖（2hPG）、糖化血红蛋白（HbA1c）、胰岛素（Ins）、C肽（C-P）、低血糖事件及肝功能指标（ALT、ALB及TBIL），并计算β细胞功能（HOMA-β）和胰岛素抵抗指数（HOMA-IR），同时比较两组治疗前后各指标的变化。 结果 两组治疗后FBG、2hPG、HbA1c、HOMA-IR及肝功能指标均较治疗前降低（P0.05），治疗组低血糖发生次数显著低于对照组（P0.05），且组间比较差异有统计学意义（P0.05）。 结论 诺和锐短期强化治疗肝功能失代偿期肝源性糖尿病能有效降低血糖，减少低血糖事件，改善肝功能恢复状况和减轻胰岛素抵抗，具有更好的临床疗效及安全性。 　　[关键词] 诺和锐；肝功能失代偿；肝源性糖尿病 　　[中图分类号] R587.1 [文献标识码] B [文章编号] 1673-9701（2015）11-0115-04 　　[Abstract] Objective To investigate the efficacy and safety of short-term intensive insulin aspart injection （Novorapid） therapy hepatogenic diabetes with liver decompensation patients. Mothods A two weeks randomized，open-label， confrolled trial comparing Novolin 30R with short-term intensive Novorapid was performed. 100 cases were randomly divided into treatment group and control group， 50 cases for each. The two groups were given traditional medical treatment， while the control group received Novolin 30R twice per day，the treatment group received Novorapid thrice per-day. The indicators such as FBG，2hPG，HbA1c， Ins，C-P，hypoglycemia incidence and liver function （ALT， AST，ALB and TBIL）were evaluated，β-cell function（HOMA-β）and insulin resistance index（HOMA-IR） were calculated. The changes of above indicators before and after therapy were compared between two groups. Results After the treatment，the FBG，2hPG，HbA1c，HOMA-IR and liver function of two groups were respectively lower than those before（P0.05），hypoglycemia incidence of the treatment group were lower than those of the control group（P0.05），while the differences between two groups was significant（P0.05）. Conclusion Short-term intensive Novorapid therapy for hepatogenic diabetes with liver decompensation can reduce FBG and 2hPG，reduce the incidence of hypoglycemia， improve liver function，and also reduce insulin resis