标题：马来酸曲美布汀联合胰岛素泵治疗对2型糖尿病并发呼吸道感染患者肠道菌群及血清APN、CRP的影响

      作者：井晓 1，马霄婷 1，黄波 1，王琳 2    西安高新医院检验科 1、内分泌科 2，陕西 西安 710075

      卷次： 2022年33卷18期

      【摘要】 目的 研究马来酸曲美布汀联合胰岛素泵治疗对2型糖尿病并发呼吸道感染患者肠道菌群及血清脂联素(APN)、C-反应蛋白(CRP)的影响。方法 选取西安高新医院于2019年9月至2021年2月收治的110例2型糖尿病合并呼吸道感染患者为研究对象，将患者按照随机数表法分为对照组和研究组，每组55例。对照组患者给予胰岛素泵治疗，研究组患者在此基础上口服马来酸曲美布汀，治疗8周。分别于治疗前后测定并比较两组患者血清中空腹血糖(FPG)及餐后2 h血糖(2 hPG)、糖化红血红蛋白(HbAlc)、血清CRP、APN和T淋巴细胞亚群(CD8+、CD3+和CD4+/CD8+)水平；测定并比较两组患者治疗前后的肠道菌群变化；评价两组患者腹泻发生率。结果 治疗后，两组患者的FPG、2 hPG和HbAlc水平与治疗前比较均显著降低，且研究组患者的FPG、2 hPG和HbAlc水平分别为(6.58±1.35) mmol/L，(7.66±1.93) mmol/L和(5.32±2.18)%，明显低于对照组的(7.97±1.62) mmol/L，(9.23±1.78) mmol/L和(6.82±2.09)%，差异均有统计学意义(P<0.05)；治疗后，两组患者血清中APN水平均明显增加，CRP水平明显降低，且研究组血清中APN水平为(17.16±2.40) mg/L，明显高于对照组的(15.22±2.47) mg/L，血清CRP水平为(4.35±1.62) mg/L，明显低于对照组的(6.61±1.45) mg/L，差异均有统计学意义(P<0.05)；治疗后，两组患者血清中CD3+、CD4+/CD8+水平均显著增加，CD8+水平均显著降低，且研究组变化幅度明显高于对照组，差异均有统计学意义(P<0.05)；治疗后，研究组患者的腹泻发生率为7.27%，明显低于对照组的32.73%，差异有统计学意义(P<0.05)；治疗后，研究组患者的肠球菌、酵母菌和肠杆菌水平分别为(6.81±0.47) CFU/g、(4.41±0.46) CFU/g、(7.44±0.61) CFU/g，明显低于对照组的(7.57±0.44) CFU/g、(5.09±0.50) CFU/g、(8.25±0.53) CFU/g，乳酸杆菌和双歧杆菌水平分别为(8.11±0.61) CFU/g、(9.14±0.66) CFU/g，明显高于对照组的(7.14±0.44) CFU/g、(8.31±0.71) CFU/g，差异均有统计学意义(P<0.05)。结论 马来酸曲美布汀联合胰岛素泵治疗可以显著降低患者的肠球菌、酵母菌和肠杆菌水平，提高乳酸杆菌和双歧杆菌水平，同时还能提高患者的血清APN水平，降低血清CRP水平。
      【关键词】 2型糖尿病；呼吸道感染；马来酸曲美布汀；胰岛素泵；肠道菌群；脂联素；C-反应蛋白
      【中图分类号】 R587.1 【文献标识码】 A 【文章编号】 1003—6350（2022）18—2329—04

Effect of trimebutine maleate combined with insulin pump therapy on intestinal microflora, serum adiponectinand C-reactive protein in patients with type 2 diabetes complicated with respiratory tract infection.
JING Xiao 1,MA Xiao-ting 1, HUANG Bo 1, WANG Lin 2. Department of Clinical Laboratory 1, Department of Endocrinology 2, Xi'anGaoxin Hospital, Xi'an 710075, Shaanxi, CHINA
【Abstract】 Objective To study the effect of trimebutine maleate combined with insulin pump therapy on theintestinal flora, serum adiponectin (APN), and C-reactive protein (CRP) in patients with type 2 diabetes complicatedwith respiratory tract infection. Methods A total of 110 patients with type 2 diabetes complicated with respiratory tractinfection treated in Xi'an Gaoxin Hospital from September 2019 to February 2021 were selected as the research objects.The patients were randomly divided into a control group and a study group according to the random number method,with 55 patients in each group. Patients in the control group were treated with insulin pump, while patients in the studygroup were treated with trimebutine maleate orally on the basis of the treatment in the control group, both for 8 weeks.The fasting blood glucose (FPG), postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbAlc), serum CRP,APN, and T lymphocyte subsets (CD8 + , CD3 + and CD4 +/CD8 +) were measured and compared before and after treat-ment. The changes of intestinal flora before and after treatment were measured and compared between the two groups.The incidence of diarrhea in the two groups was evaluated. Results After treatment, the levels of FPG, 2 hPG, andHbAlc in the two groups were significantly lower than those before treatment, and the levels in the study group were(6.58±1.35) mmol/L, (7.66±1.93) mmol/L, and (5.32±2.18)%, respectively, which were significantly lower than (7.97±1.62) mmol/L, (9.23±1.78) mmol/L, and (6.82±2.09)% in the control group (P<0.05). After treatment, the levels of APNand CRP in the serum of both groups increased significantly; the level of APN in the study group was (17.16±2.40) mg/L,which was significantly higher than (15.22±2.47) mg/L in the control group; serum CRP level was (4.35±1.62) mg/L,