【摘要】 目的:探讨2型糖尿病性脂肪肝患者控制高血糖的最佳方法。方法:收集本院内分泌科32例2型糖尿病性脂肪肝患者自愿分为甘精胰岛素联合门冬胰岛素治疗组(GA组,n=16)与重组人胰岛素N联合门冬胰岛素治疗组(NA组,n=16),观察每组病人治疗前后各项,临床指标变化。结果:治疗后GA组和NA组空腹血糖(5.25±0.64)mmol/L、6.51±1.23)mmol/L和餐后2 h血糖(7.32±1.05)mmol/L、(9.46±0.52)mmol/L、所需胰岛素剂量(36.8±0.7)IU、(42.8±1.8)IU、血糖波动状况[(1.92±0.87)、(2.95±0.83)mmol/L]、低血糖和黎明现象发生率及血糖达标时间等各项指标相比较,GA组明显低于NA组(P<0.05),同时肝功能改善更明显。结论:胰岛素强化治疗是2型糖尿病性脂肪肝控制血糖的理想治疗方法,但甘精胰岛素联合门冬胰岛素治疗更有优势。更多还原

【Abstract】 Objective:To investigate the optimal treatment of blood sugar control in type 2 diabelics with fatty liver.Methods:32 cases of type 2 diabetics with fatty liver were voluntarily divided into the Glargine and Aspart insulins treated group(group GA,n = 16) and rh-insulin plus aspart insulin treated group(group NA,n = 16).The changes of clinical measures in each group were observed before and after treatment.Results:The levels of fasting plasma glucose and 2 hours postprandial glucose,insulin dosage,blood glucose fluctuation in group GA[(5.25±0.64) mmol/L,(7.32±1.05 ) mmol/L,(36.8±0.7 ) IU,(1.92±0.87 ) mmol/L]were significantly lower than those in group NA[(6.51±1.23) mmol/L,(9.46±0.52) mmol/L,(42.8±1.8 )IU,(2.95±0.83) mmol/L,all P<0.05]. Simultaneously,time to blood sugar control,incidence of hypoglycemia and dawn phenomenon in group GA were significantly shorter or lower than those in group NA(all P<0.05 ).The liver function of group GA was improved earlier.Conclusion:Intensive insulin therapy might be the perfect choice for type 2 diabetic with fatty liver.Glargine and aspart insulins in combination may be advantageous over treatment with rh-insulin plus insulin aspart.更多还原