2型糖尿病患者不同治疗方案短期内对Hcy的影响

Short-Term Effects of Different Treatment Regimens on Hcy in Patients with Type 2 Diabetes

摘要: 目的：通过对2型糖尿病患者不同治疗方案治疗前后Hcy的测定，从而探究不同降糖方案对Hcy的影响，为糖尿病患者选择降糖方案治疗后达到血糖控制及降糖之外获益提供新的理论及临床依据。方法：从2022年11月至2023年11月于华北理工大学附属医院住院的患者中选取2型糖尿病病人100例。按照治疗方案的不同，将患者分为注射胰岛素联合口服降糖药治疗组(A组)和单纯注射胰岛素治疗组(B组)，每组各50例。检测治疗前后Hcy水平，分析不同降糖方案在治疗后对于Hcy影响。结果：1) 基线资料比较：χ²检测结果显示，两组间性别及吸烟史差异无统计学意义。t检验结果显示两组在年龄、BMI、血脂、病程、住院时间、糖化血红蛋白方面差异无统计学意义。两组在FPG、IR方面差异有统计学意义。2) 两组治疗后Hcy水平均有所降低，但A组降低的程度大于B组，差异有统计学意义(P < 0.05)。多因素Logistic回归分析：在控制了无可比性因素(空腹血糖、胰岛素抵抗指数、肌酐)后，两种治疗方案对Hcy的影响仍有区别。结论：短时间内两种治疗方案对Hcy的影响不同，口服降糖药联合胰岛素降低Hcy水平的作用优于单纯注射胰岛素。

Abstract: Objective: Through the measurement of Hcy before and after treatment with different treatment regimens for type 2 diabetic patients, thus exploring the effect of different glucose-lowering regimens on Hcy, and providing new theoretical and clinical basis for diabetic patients to achieve glycemic control and benefit beyond glucose-lowering after choosing glucose-lowering regimens for treatment. Methods: One hundred patients with type 2 diabetes mellitus were selected from patients hospitalized at the Affiliated Hospital of North China University of Technology from November 2022 to November 2023. According to the different treatment regimens, the patients were divided into the group treated with injectable insulin combined with oral hypoglycemic agents (group A) and the group treated with injectable insulin alone (group B), with 50 cases in each group. Hcy levels were measured before and after treatment, and the effect of different glucose-lowering regimens on Hcy was analyzed. Results: 1) Comparison of baseline information: χ² test showed no statistically significant differences in gender and smoking history between the two groups. T-test showed no statistically significant differences in age, BMI, lipids, duration of illness, length of hospital stay, and glycated hemoglobin between the two groups. There was a statistically significant difference between the two groups in FPG and IR. 2) Hcy levels decreased in both groups after treatment, but the degree of reduction was greater in group A than in group B, and the difference was statistically significant (P < 0.05). Multi-factor logistic regression analysis: after controlling for non-comparable factors (fasting glucose, insulin resistance index, creatinine), the effect of the two treatment regimens on Hcy remained different. Conclusion: The effects of the two treatment regimens on Hcy differed over a short period of time, with oral hypoglycemic agents combined with insulin having a better effect on lowering Hcy levels than insulin injection alone.