西格列汀联合门冬胰岛素治疗老年2型糖尿病患者的疗效及对脂代谢、炎症因子、同型半胱氨酸的影响

The therapeutic efficacy of sitagliptin combined with insulin aspart in elderly patients with type 2 diabetes mellitus

摘要:

目的 探讨西格列汀联合门冬胰岛素治疗老年2型糖尿病（T2DM）患者的疗效，及其对患者脂代谢、炎症因子、同型半胱氨酸（Hcy）的影响。方法 选取2018年1月—2019年12月台州市中心医院和宁波大学医学院附属医院收治的老年T2DM患者60例，采用随机数字表法分为观察组和对照组，每组30例。观察组采用西格列汀联合门冬胰岛素治疗，对照组采用门冬胰岛素治疗，均治疗3个月。比较两组患者治疗3个月总有效率，治疗前与治疗3个月患者血脂、炎症因子［C反应蛋白（CRP）、白细胞介素-6（IL-6）和IL-18］和Hcy水平的变化。结果 观察组总有效率高于对照组（P <0.05）。观察组治疗前后低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、总胆固醇和甘油三酯的差值均大于对照组（P <0.05）。观察组治疗前后CRP、IL-6和IL-18的差值均大于对照组（P <0.05）。观察组治疗前后Hcy的差值大于对照组（P <0.05）。结论 西格列汀联合门冬胰岛素治疗老年T2DM患者疗效良好，且可改善血脂代谢，减轻炎症反应，降低Hcy水平。

Abstract:

Objective To investigate the efficacy of sitagliptin combined with insulin aspart in elderly patients with type 2 diabetes mellitus (T2DM) and its effects on glucose and lipid metabolism, inflammatory factors and homocysteine (Hcy).Methods A total of 60 elderly patients with T2DM admitted to Taizhou Central Hospital and the Affiliated Hospital of Medical School of Ningbo University from January 2018 to December 2019 were randomly divided into observation group (30 cases) and control group (30 cases). The observation group was treated with sitagliptin combined with insulin aspart, while the control group was treated with insulin aspart. The treatment course of the two groups was 3 months. The overall effective rate after 3 months of treatment in the two groups was compared, and the changes of lipid metabolism, inflammatory factors [C-reactive protein (CRP), interleukin-6 (IL-6) and interleukin-18 (IL-18)], and Hcy levels before and after 3 months of treatment were compared.Results The overall effective rate of the observation group was higher than that of the control group (P < 0.05). The differences of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), total cholesterol (TC) and triglyceride (TG) before and after treatment were higher in observation group compared with the control group (P < 0.05). As for the inflammatory factors, the differences of CRP, IL-6 and IL-18 before and after treatment in observation group were greater than those in control group (P < 0.05). Besides, the difference of Hcy before and after treatment in the observation group was also higher than that in the control group (P < 0.05).Conclusions Sitagliptin combined with insulin aspart has a good curative effect on elderly patients with T2DM, and can improve blood lipid metabolism, ameliorate inflammatory responses and decrease Hcy level.