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目的观察甘精胰岛素联合阿卡波糖治疗肝移植术后糖尿病(PTDM)的疗效及安全性。方法肝移植术后糖尿病患者60例,随机分为A组(32例)和B组(28例)。A组给予甘精胰岛素皮下注射联合口服阿卡波糖,B组给予预混胰岛素(诺和灵30R)多次皮下注射,疗程均为3个月,治疗目标为FBG≤7.0mmol/L、2hBG≤10mmol/L。结果 50例患者完成治疗。治疗后两组患者血糖均达标,免疫抑制剂剂量均较治疗前降低(P<0.05)。A组治疗后胰岛素用量及低血糖发生率低于B组(P<0.05),两组急性排斥及其他不良事件比较,差异无统计学意义(P>0.05)。结论甘精胰岛素联合阿卡波糖应用于肝移植术后糖尿病患者可达到良好的血糖控制,且依从性较好。
Objective To observe the efficacy and safety of glargine combined with acarbose in the treatment of post-liver transplantation diabetes mellitus (PTDM). Methods Sixty diabetic patients after liver transplantation were randomly divided into group A (n = 32) and group B (n = 28). Group A was given insulin glargine subcutaneously plus oral acarbose, group B was given premixed insulin (norepinephrine 30R) multiple subcutaneous injections, the course of treatment were 3 months, the treatment target FBG ≤ 7.0mmol / L, 2hBG ≤ 10mmol / L. Results 50 patients completed the treatment. After treatment, the blood glucose of both groups reached the standard, and the dosage of immunosuppressive agents was lower than that before treatment (P <0.05). The insulin dosage and the incidence of hypoglycemia in group A were lower than those in group B (P <0.05). There was no significant difference in acute rejection and other adverse events between two groups (P> 0.05). Conclusion The application of glargine and acarbose in diabetic patients with liver transplantation can achieve good glycemic control with good compliance.