目的 探討沙格列汀聯(lián)合胰島素泵短期強化降血糖治療對2型糖尿病患者β細胞分泌功能及胰島素抵抗的影響。方法 選擇上海市奉賢區(qū)中心醫(yī)院2017年5月-2018年5月收治的101例2型糖尿病患者，根據(jù)隨機數(shù)字表法分為觀察組（52例）及對照組（49例）。對照組給予胰島素泵短期強化治療，觀察組在對照組基礎(chǔ)上給予二肽基肽酶Ⅳ（DPP-4）抑制劑沙格列汀，兩組治療療程均為2周。對比兩組患者臨床療效、治療前后的血糖相關(guān)指標、胰島素β細胞功能變化、血糖達標時間、胰島素日用量、低血糖發(fā)生率及血糖達標率。結(jié)果 治療后，觀察組總有效率為88.5%，顯著高于對照組的73.5%（P<0.05）。治療后，兩組的空腹血糖（FPG）、餐后2 h血糖（2 h PG）均明顯低于治療前，胰島β細胞功能指數(shù)（HOMA-β）、C肽水平（C-p2）均明顯高于治療前，同組治療前后比較差異均有統(tǒng)計學意義（P<0.05）；且治療后觀察組的C-p2明顯高于對照組（P<0.05）。對照組的胰島素抵抗指數(shù)（HOMA-IR）治療前后對比無統(tǒng)計學意義；治療后觀察組的HOMA-IR明顯低于治療前和對照組，差異有統(tǒng)計學意義（P<0.05）。觀察組的血糖達標時間及胰島素日用量明顯低于對照組，血糖達標率明顯高于對照組，組間差異有統(tǒng)計學意義（P<0.05）。兩組低血糖發(fā)生率對比無統(tǒng)計學意義。結(jié)論 沙格列汀聯(lián)合胰島素泵短期強化降血糖治療2型糖尿病可更快、平穩(wěn)的控制血糖，更好的改善胰島β細胞分泌功能及胰島素抵抗。

Objective To investigate the effects of short-term intensive hypoglycemic therapy with insulin pump combined with saxagliptin on the secretion function of β cells and insulin resistance in patients with type 2 diabetes mellitus. Methods Patients (101 cases) with type 2 diabetes mellitus from May 2017 to May 2018 in Central Hospital of Shanghai Fengxian District were chosen, and who were divided into the observation group (52 cases) and control group (49 cases) according randomly number methods. The control group were given short-term intensive hypoglycemic therapy with insulin pump, the observation group were given saxagliptin on the base of control group. Patients in two groups were treated for 2 weeeks. The clinical efficacy was compared, and the blood glucose indexes, changes of insulin β cells functions before and after treatment in two groups were compared. The time of blood glucose reaching the standard, daily dosage of insulin, incidence of hypoglycemia, and the rate of reaching the standard of blood glucose of two groups were compared. Results After treatment, the total efficacy of observation group was 88.5%, which was obviously higher than 73.5% in the control group (P<0.05). After treatment, the FPG, 2 h PG of two groups were decreased than before, the HOMA-β, C-p2 were higher than before (P<0.05), and the C-p2 in the observation group was higher than control group after treatment (P<0.05). The HOMA-IR of control group had no significant different between before and after treatment. The HOMA-IR of observation group after treatment was obviously lower than before (P<0.05). The reaching time of the blood glucose standard and the daily dosage of insulin in the observation group were significantly lower than control group, and the reaching rate of the blood glucose standard was significantly higher than that in the control group (P<0.05). The incidence of hypoglycemia in two groups was not statistically significant. Conclusion The short-term enhancement of insulin pump and saxagliptin in treatment of type 2 diabetes mellitus could control blood glucose more rapidly and steadily, and improve the secretion function of islet hypoxia cells and insulin resistance.