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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。
Objective: To explore the best method of controlling hyperglycemia in type 2 diabetic patients with fatty liver. Methods: Thirty-two patients with type 2 diabetic fatty liver were collected and randomly divided into insulin glargine and insulin aspart (GA group, n = 16) and recombinant human insulin N combined with insulin aspart insulin treatment group (NA group , n = 16). The changes of clinical indexes in each group before and after treatment were observed. Results After fasting blood glucose (5.25 ± 0.64) mmol / L, 6.51 ± 1.23 mmol / L and postprandial 2 h blood glucose (7.32 ± 1.05) mmol / L and (9.46 ± 0.52) mmol / L (36.8 ± 0.7) IU, (42.8 ± 1.8) IU, blood glucose fluctuation [(1.92 ± 0.87), (2.95 ± 0.83) mmol / L], incidence of hypoglycemia and dawn, Compared with other indicators, GA group was significantly lower than the NA group (P <0.05), while liver function improved more significantly. Conclusion: Intensive insulin therapy is an ideal treatment for type 2 diabetic fatty liver to control blood sugar, but insulin glargine combined with insulin aspart is more advantageous.