【摘要】 目的探讨西格列汀联合恩格列净治疗难治性糖尿病的疗效及对血清白细胞介素(IL)-4、IL-6及肿瘤坏死因子(TNF)-α水平的影响。方法内分泌科就诊的难治性糖尿病94例按照治疗方法分为观察组(47例)和对照组(47例),对照组予以胰岛素治疗,观察组此基础上加用西格列汀联合恩格列净,比较两组治疗后血糖控制情况、达标时间、胰岛素用量、血糖波动幅度、低血糖发生情况等评估疗效,同时比较两组治疗前后血清IL-4、IL-6及TNF-α水平。结果两组治疗2 w后空腹血糖、餐后2 h血糖较治疗前下降,观察组下降更明显(P<0.05);治疗后两组血糖波动幅度均减少,观察组改变更明显(P<0.05)。观察组及对照组血糖达标时间、胰岛素用量、低血糖发生率差异有统计学意义(P<0.05)。与治疗前相比,两组治疗后IL-4、IL-6及TNF-α水平显著下降,且观察组改变更显著(P<0.05)。结论西格列汀联合恩格列净治疗难治性糖尿病可以降低IL-4、IL-6及TNF-α水平,临床疗效确切。更多还原

【Abstract】 Objective To investigate the effect of siglitatin combined with neglitazim in the treatment of refractory diabetes mellitus and its effect on serum levels of IL-4,IL-6 and TNF-α. Methods 94 patients with refractory diabetes mellitus were divided into observation group(n=47) and control group(n=47). The control group was treated with insulin and the observation group was treated with siglitatin plus neglitazim on the basis of the control group. The control of blood glucose, the time to reach the standard, the dosage of insulin, the fluctuation of blood glucose and the incidence of hypoglycemia were compared between the two groups. The serum levels of IL-4,IL-6 and TNF-α were compared before and after treatment. Results The levels of fasting blood glucose and postprandial blood glucose were decreased significantly in the two groups after 2 weeks of treatment(P<0.05). After treatment, the fluctuation range of blood glucose in the two groups was significantly decreased(P<0.05), while that in observation group was more obvious than that in control group(P<0.05). The differences of the time of blood glucose reaching the standard, the dosage of insulin and the incidence of hypoglycemia between observation and control groups were statistically significant(P<0.05). After treatment, the levels of IL-4,IL-6 and TNF-α were significantly lower than those before treatment, and those in observation group were significantly lower than those in control group(P<0. 05). Conclusions Siglitatin combined with neglitazim could reduce the levels of IL-4,IL-6 and TNF-α of refractory diabetes.更多还原