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目的分析西格列汀联合大剂量胰岛素对非胰岛素依赖型糖尿病患者血清miR-342-5p和miR-423-5p表达的影响,探讨该治疗方案对患者微血管并发症的预防机制。方法选取我院2012年6月-2014年6月收治的182例非胰岛素依赖型糖尿病患者,按照随机数字表分为观察组及对照组,各91例,均给予大剂量胰岛素治疗。观察组在此基础上加用西格列汀。比较2组患者疗程结束后血清miR-342-5p和miR-423-5p表达的变化。结果 2组患者治疗后FBG、2h PG、Hb A1c均显著降低,观察组降低更为明显(P<0.05)。观察组治疗后胰岛素用量显著降低(P<0.05),对照组未见明显变化(P>0.05)。治疗前后2组患者BMI均未见明显变化(P>0.05)。观察组、对照组患者治疗期间低血糖反应发生率分别为14.3%、16.5%,差异未见明显统计学意义(P>0.05)。2组患者治疗后TC、LDL-C水平均未见明显变化。对照组患者治疗前后TG水平也未见明显变化(P>0.05),治疗后HDL-C显著降低(P<0.05);观察组患者治疗后TG显著降低,HDL-C显著升高。观察组患者治疗后miR-342-5p和miR-423-5p表达水平均显著降低,对照组患者治疗后上述指标表达水平显著升高(P<0.05)。结论西格列汀联合大剂量胰岛素能够有效降低非胰岛素依赖型糖尿病患者血清miR-342-5p和miR-423-5p表达水平,对其微血管并发症的预防具有重要意义,具有确切的疗效及良好的安全性,值得进一步深入研究。
Objective To investigate the effects of sitagliptin and high-dose insulin on the expression of miR-342-5p and miR-423-5p in non-insulin dependent diabetic patients and the preventive mechanism of this treatment on microvascular complications. Methods A total of 182 patients with non-insulin-dependent diabetes mellitus admitted to our hospital from June 2012 to June 2014 were divided into observation group and control group according to random number table. Each group received 91 doses of high-dose insulin. The observation group added sitagliptin on this basis. The changes of serum miR-342-5p and miR-423-5p expression after the end of treatment were compared between the two groups. Results After treatment, the FBG, 2h PG and Hb A1c in both groups were significantly lower than those in the observation group (P <0.05). The amount of insulin in observation group decreased significantly (P <0.05), but there was no significant change in control group (P> 0.05). There was no significant change in BMI between the two groups before and after treatment (P> 0.05). The incidences of hypoglycaemia in observation group and control group were 14.3% and 16.5% respectively, with no significant difference (P> 0.05). After treatment, TC and LDL-C levels did not change significantly in both groups. There was no significant difference in TG level before and after treatment in the control group (P> 0.05). After treatment, the HDL-C level was significantly lower (P <0.05). The TG in the observation group was significantly lower and HDL-C was significantly higher after treatment. After treatment, the expression of miR-342-5p and miR-423-5p in the observation group was significantly lower than that in the control group (P <0.05). Conclusions Sitagliptin combined with high-dose insulin can effectively reduce the expression of miR-342-5p and miR-423-5p in non-insulin dependent diabetic patients, which is of great significance for the prevention of microvascular complications and has definite curative effect and good effect The safety, it is worth further in-depth study.