目的 比较三餐前短效+睡前中效胰岛素(诺和灵R+诺和灵N)和三餐前速效和中效的预混胰岛素(诺和锐30)的两种胰 岛素强化治疗方案在2型糖尿病合并心肌梗塞患者中的疗效及安全性。方法 将41例入选患者随机分成2组，比较 两组患者治疗前后血糖达标时间、胰岛素用量、低血糖发生率。结果 三餐前注射诺和锐30和三餐前注射诺和灵 R +睡前注射诺和灵N这两种方案的达标时间分别为16.6±5.2天和15.4±4.1天(P>0.05)，低血糖发生率为9.5%和 19.04%(P<0.05)，日均胰岛素使用量为50.5±6.1U和55.2±6.8U(P<0.05)。结论 对于2型糖尿病合并心肌梗塞患 者，三餐前速效和中效的预混胰岛素的方案相比三餐前短效+睡前中效胰岛素的方案低血糖发生率低，胰岛素总剂 量相对较小，病人使用的依从性强。

Objective To compare the efficacy and safety of two kinds of intensive insulin therapy in type 2 diabetes patients with myocardial infarction: thrice preprandial injection of insulin Novolin R and injection of Novolin N at bedtime; thrice preprandial injection of premixed insulin aspart 30. Methods The 41 cases selected patients were randomly divided into two groups, compare the blood glucose level, therapeutic time, dosage of insulin and occurrence of hypoglycemia. Results Compare to thrice preprandial injection of insulin Novolin R and injection of Novolin N at bedtime; thrice preprandial injection of insulin aspart 30; the time for blood glucose control were (16.6±5.2)d and (15.4±4.1)d, P>0.05; occurrence of hypoglycemia were 9.5% and 19.04%, P<0.05; dosage of insulin were (50.5±6.1)U and (55.2±6.8) U, P<0.05. Conclusion For type 2 diabetes patients with myocardial infarction, the treatment of thrice preprandial injection of premixed insulin aspart 30 compare to the treatment of thrice preprandial injection of insulin Novolin R and injection of Novolin N at bedtime is less occurrence of hypoglycemia, small total insulin dose, more patient compliance.