预混胰岛素类似物联合瑞格列奈对2型糖尿病合并肺结核患者的免疫功能和血糖的影响

目的探讨预混胰岛素类似物与瑞格列奈在糖尿病合并肺结核中的应用价值。方法选择于2010年8月至2013年8月闻人院治疗的2型糖尿病合并肺结核患者164例，随机分成2组。2组患者均在肺结核四联化疗的基础上，对照组采用预混胰岛素类似物诺和锐30R联合安慰剂，观察组采用预混胰岛素类似物诺和锐30R联合瑞格列奈进行降糖治疗，疗程均为3个月。检测治疗前后所有患者的T淋巴细胞亚群绝对值水平、血糖相关指标和血糖波动情况。结果治疗后，2组患者T细胞亚群绝对值水平均高于治疗前，且观察组患者的CD3＋、CIM＋、CD8＋、CD4＋／CD8＋水平均高于对照组；2组患者血糖水平均低于治疗前，且观察组患者的FBG、2hPBG、HbAle水平，以及血糖波动次数和日间血糖平均差绝对值均低于对照组。结论预混胰岛素联合瑞格列奈可以更为有效地改善免疫功能、降低血糖水平和控制血糖波动，是糖尿病合并肺结核患者理想的降糖方案之一。

Effect of premixed insulin analogues combined with repaglinide on immune function and blood glucose levels of type 2 diabetes patients complicated with pulmonary tu- berculosis

AIM To investigate the effect of premixed insulin analogues combined with repaglinide on immune function and blood glucose levels of type 2 diabetes patients complicated with pulmonary tuberculosis. METHODS A to- tal of 164 type 2 diabetes patients complicated with pulmonary tuberculosis from August 2010 to August 2013 in our hos- pital were enrolled and randomly divided into 2 groups. Patients of 2 groups were given quadruple chemotherapy and con- trol group was given premixed insulin aspart 30R combined with placebo, observation group was given premixed insulin aspart 30R combined with repaglinide, treatment courses were all 3 months. Then absolute levels of T lymphocyte sub- sets, blood glucose related index and blood glucose fluctuation were observed. RESULTS After treatment, T cell subsets absolute levels were higher,and observation group patients＇ CD3 ＋ , CD4＋ , CD8 ＋ , CD4＋/CD8 ＋ levels were higher than control group; after treatment, blood glucose levels were lower, and observation group patients＇ FBG, 2hPBG, HbAlc levels and blood glucose fluctuation frequency, absolute value of daytime mean blood glucose difference were lower than control group. CONCLUSION Premixed insulin analogues combined with repaglinide are ideal hypoglycemic scheme of type 2 diabetes patients complicated with pulmonary tuberculosis for it can more effectively improve immune function, re- duce blood glucose levels and control blood glucose fluctuation.