精蛋白锌重组赖脯胰岛素与精蛋白重组人胰岛素治疗初诊2型糖尿病的疗效、安全性及成本分析研究
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摘要
目的:比较精蛋白锌重组赖脯胰岛素混合注射液与精蛋白重组人胰岛素混合注射液在治疗2型糖尿病中的临床疗效、安全性和成本。方法:选取2015年6月-2018年2月本院门诊收治的初诊2型糖尿病患者60例。按照随机数字表法将其分为A组和B组,各30例。A组接受精蛋白重组人胰岛素混合注射液早晚两针注射治疗,B组接受精蛋白锌重组赖脯胰岛素混合注射液早晚两针注射治疗。12周结束后,比较两组患者治疗前后血糖控制情况、低血糖发生率、体重和治疗成本等。结果:治疗后,B组空腹及餐后2 h血糖、HbA1c水平均低于A组,差异均有统计学意义(P<0.05);B组低血糖发生率为3.3%,低于A组的20.0%(P<0.05);治疗前后,两组体重及增幅比较,差异均无统计学意义(P>0.05);B组胰岛素每日用量低于A组,但胰岛素费用及总费用均高于A组,差异均有统计学意义(P<0.05)。结论:精蛋白锌重组赖脯胰岛素混合注射液治疗效果更佳,低血糖的发生率也较低,同时夜间无低血糖发生,体重增加无明显差异,使用方便,但治疗费用更高。
Objective:To compare and observe the efficacy,safety and cost of Mixed Protamine Zinc Recombinant Human Insulin Lispro Injection and Premixed Protamine Recombinant Human Insulin Injection in treatment of newly diagnosed type 2 diabetes.Method:A total of 60 patients with newly diagnosed type 2 diabetes admitted to our hospital from June 2015 to February 2018 were selected.According to the random number table method,they were divided into A group and B group,30 cases in each group.A group received two injections of premixed protamine recombinant human insulin injection in the morning and evening,B group received two injections of mixed protamine Zinc recombinant human insulin lispro injection in the morning and evening.After12 weeks,blood sugar control,incidence of hypoglycemia,body weight and treatment cost were compared between two groups before and after treatment.Result:After treatment,the fasting and 2 h postprandial blood sugar and HbA1 c levels in B group were lower than those of A group,the differences were statistically significant(P<0.05).The incidence of hypoglycemia in B group was 3.3%,lower than 20.0% in A group(P<0.05).Before and after treatment,the body weight and growth rate of two groups were compared,the differences were not statistically significant(P>0.05).The daily dosage of insulin in B group was lower than that of A group,but the insulin cost and total cost of in B group were higher than those of A group,the differences were statistically significant(P<0.05).Conclusion:Mixed protamine Zinc recombinant human insulin lispro injection has better therapeutic effect,lower incidence of hypoglycemia,no hypoglycemia at night,no significant difference in weight gain,easy to use,but higher treatment costs.
Objective:To compare and observe the efficacy,safety and cost of Mixed Protamine Zinc Recombinant Human Insulin Lispro Injection and Premixed Protamine Recombinant Human Insulin Injection in treatment of newly diagnosed type 2 diabetes.Method:A total of 60 patients with newly diagnosed type 2 diabetes admitted to our hospital from June 2015 to February 2018 were selected.According to the random number table method,they were divided into A group and B group,30 cases in each group.A group received two injections of premixed protamine recombinant human insulin injection in the morning and evening,B group received two injections of mixed protamine Zinc recombinant human insulin lispro injection in the morning and evening.After12 weeks,blood sugar control,incidence of hypoglycemia,body weight and treatment cost were compared between two groups before and after treatment.Result:After treatment,the fasting and 2 h postprandial blood sugar and HbA1 c levels in B group were lower than those of A group,the differences were statistically significant(P<0.05).The incidence of hypoglycemia in B group was 3.3%,lower than 20.0% in A group(P<0.05).Before and after treatment,the body weight and growth rate of two groups were compared,the differences were not statistically significant(P>0.05).The daily dosage of insulin in B group was lower than that of A group,but the insulin cost and total cost of in B group were higher than those of A group,the differences were statistically significant(P<0.05).Conclusion:Mixed protamine Zinc recombinant human insulin lispro injection has better therapeutic effect,lower incidence of hypoglycemia,no hypoglycemia at night,no significant difference in weight gain,easy to use,but higher treatment costs.
引文
[1]周晨虹,张丽坤.诺和锐30强化与诺和灵30R治疗2型糖尿病的临床疗效对比分析[J].中国实用医药,2016,11(19):202-203.
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[8]阚芳芳,方福生,孙般诺,等.不同发病年龄老年2型糖尿病的临床特点[J].中华保健医学杂志,2015,17(5):360-363.
[9]陈英刚,吕春苗,陈海君,等.利拉鲁肽联合诺和锐30对2型糖尿病患者糖代谢指标和胰岛功能及生化指标的影响[J].中国慢性病预防与控制,2016,24(9):671-674.
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[12]Vora J,Cohen N,Evans M,et al.Intensifying insulin regimen after basal insulin optimization in adults with type 2 diabetes:a24-week,randomized,open-label trial comparing insulin glargine plus insulin glargine plus insulin glulisine with biphasic insulin aspart(LanScape)[J].Diabetes Obes Metab,2015,17(12):1133-1141.
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[14]张雪莲,崔玲,罗斌,等.门冬胰岛素30与预混人胰岛素治疗中国2型糖尿病患者的Meta分析[J].中国糖尿病杂志,2018,26(9):723-732.
[15]谢爱霞,李建宁,李农,等.2型糖尿病患者HbA1c与血脂、血液流变学关系分析[J].医学理论与实践,2015,28(3):376-377.
[16]陈海静,孙海燕,刘红丹.精蛋白锌重组赖脯胰岛素混合注射液治疗初发2型糖尿病的疗效及安全性观察[J].中国药师,2016,19(8):1502-1503.
[17]梁辉,蒋辉.甘精胰岛素联合瑞格列奈与精蛋白锌重组赖脯胰岛素混合注射液治疗2型糖尿病的疗效与安全性比较[J].中国执业药师,2017,14(10):36-38.
[18]韦艳鸿,庞翠军,肖常青.精蛋白锌重组赖脯胰岛素混合注射液(50R)强化治疗初诊2型糖尿病疗效观察[J].中华实用诊断与治疗杂志,2016,30(4):407-408.
[19]邢洁,贾彦疆.精蛋白锌重组赖脯胰岛素混和注射液与门冬胰岛素30注射液治疗2型糖尿病的临床分析[J].继续医学教育,2015,29(12):149-150.
[20]林旋,郎江明,魏爱生,等.精蛋白锌重组赖脯胰岛素混合注射液对2型糖尿病患者糖代谢与免疫功能的影响及其炎症机制研究[J].中国生化药物杂志,2015,35(4):144-146.
[2]陈璐璐.中国2型糖尿病合并肥胖综合管理专家共识[J].中华内分泌代谢杂志,2016,13(10):11-12.
[3]Wang L,Gao P,Zhang M,et al.Prevalence and Ethnic Pattern of Diabetes and Prediabetes in China in 2013[J].JAMA,2017,317(24):2515-2523.
[4]中华医学会糖尿病学分会.中国血糖监测临床应用指南(2015年版)[J].中华糖尿病杂志,2015,7(10):603-613.
[5]刘超,时立新,赵志刚.预混胰岛素临床应用专家共识(2016年版)[J].药品评价,2016,13(9):5-11.
[6]Schauer P R,Bhatt D L,Kirwan J P,et al.Bariatric surgery versus intensive medical therapy for diabetes-5-year outcomes[J].N Engl J Med,2017,376(7):641-651.
[7]中华医学会糖尿病学分会.中国2型糖尿病防治指南(2017年版)[J].中华糖尿病杂志,2018,10(1):4-6.
[8]阚芳芳,方福生,孙般诺,等.不同发病年龄老年2型糖尿病的临床特点[J].中华保健医学杂志,2015,17(5):360-363.
[9]陈英刚,吕春苗,陈海君,等.利拉鲁肽联合诺和锐30对2型糖尿病患者糖代谢指标和胰岛功能及生化指标的影响[J].中国慢性病预防与控制,2016,24(9):671-674.
[10]张继斌,陈胜业,郭贞臻.优泌乐25治疗2型糖尿病的疗效观察[J].中国医药指南,2016,14(10):131-133.
[11]李延兵,马建华,母义明.2型糖尿病短期胰岛素强化治疗临床专家指导意见[J].药品评价,2017,14(9):5-12,26.
[12]Vora J,Cohen N,Evans M,et al.Intensifying insulin regimen after basal insulin optimization in adults with type 2 diabetes:a24-week,randomized,open-label trial comparing insulin glargine plus insulin glargine plus insulin glulisine with biphasic insulin aspart(LanScape)[J].Diabetes Obes Metab,2015,17(12):1133-1141.
[13]吴伟.初诊2型糖尿病患者中黎明现象与晨峰血压相关性研究[J].中国处方药,2015,13(6):112.
[14]张雪莲,崔玲,罗斌,等.门冬胰岛素30与预混人胰岛素治疗中国2型糖尿病患者的Meta分析[J].中国糖尿病杂志,2018,26(9):723-732.
[15]谢爱霞,李建宁,李农,等.2型糖尿病患者HbA1c与血脂、血液流变学关系分析[J].医学理论与实践,2015,28(3):376-377.
[16]陈海静,孙海燕,刘红丹.精蛋白锌重组赖脯胰岛素混合注射液治疗初发2型糖尿病的疗效及安全性观察[J].中国药师,2016,19(8):1502-1503.
[17]梁辉,蒋辉.甘精胰岛素联合瑞格列奈与精蛋白锌重组赖脯胰岛素混合注射液治疗2型糖尿病的疗效与安全性比较[J].中国执业药师,2017,14(10):36-38.
[18]韦艳鸿,庞翠军,肖常青.精蛋白锌重组赖脯胰岛素混合注射液(50R)强化治疗初诊2型糖尿病疗效观察[J].中华实用诊断与治疗杂志,2016,30(4):407-408.
[19]邢洁,贾彦疆.精蛋白锌重组赖脯胰岛素混和注射液与门冬胰岛素30注射液治疗2型糖尿病的临床分析[J].继续医学教育,2015,29(12):149-150.
[20]林旋,郎江明,魏爱生,等.精蛋白锌重组赖脯胰岛素混合注射液对2型糖尿病患者糖代谢与免疫功能的影响及其炎症机制研究[J].中国生化药物杂志,2015,35(4):144-146.