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目的比较糖尿病患者急性心肌梗死(AMI)后使用重组人胰岛素(RHI)和人胰岛素类似物降糖治疗的效果。方法选择合并糖尿病的AMI患者32例,分为RHI组18例,地特胰岛素(Det)联合门冬胰岛素(Asp)组(Det+Asp组)14例。比较两组出院时及出院1个月后血糖控制水平,住院期间及出院后1个月内的低血糖发生率;并比较两组在出院后1个月内体重的变化。结果出院时及出院1个月后Det+Asp组FPG、2hPG均低于RHI组(P<0.01);住院期间及出院后1个月内Det+Asp组低血糖发生率均少于RHI组(P<0.05)。Det+Asp组体重增加少于RHI组(P=0.046)。两组间胰岛素用量及住院天数无差异。两组在观察期内均无新发心血管事件。结论合并糖尿病的AMI患者使用Det联合Asp治疗更有利于血糖控制,可降低低血糖发生率,并减少体重增加。
Objective To compare the effect of hypoglycemic treatment with recombinant human insulin (RHI) and human insulin analogs after acute myocardial infarction (AMI) in diabetic patients. Methods Thirty-two AMI patients with diabetes mellitus were selected and divided into 18 cases in RHI group and 14 cases in Det plus Asp group (Det + Asp group). The levels of blood glucose control, the duration of hospitalization and the incidence of hypoglycemia within 1 month after hospital discharge were compared between the two groups after discharge and one month after discharge. The changes of body weight within one month after discharge were compared between the two groups. Results The levels of FPG and 2hPG in Det + Asp group were significantly lower than those in RHI group (P <0.01) at discharge and 1 month after discharge. The incidence of hypoglycemia in Det + Asp group was lower than that in RHI group during hospitalization and within 1 month after discharge P <0.05). Body weight gain was lower in the Det + Asp group than in the RHI group (P = 0.046). Insulin dosage and hospital stay between the two groups no difference. No new cardiovascular events occurred in either group during the observation period. Conclusion The combination of Det combined with Asp in diabetic patients with AMI is more conducive to blood sugar control, can reduce the incidence of hypoglycemia, and reduce weight gain.