CGMS分析那格列奈与阿卡波糖治疗老年人2型糖尿病疗效比较  

Comparative Study on the Therapeutic Efficacy of Nateglinide VersusAcarbose in Treatment of Type 2 Diabetic Patients in the Elderlyby Continues Glucose Monitoring System

作　　者：毕明慧[1] 

机构地区：[1]上海市徐汇区中心医院老年病科,上海200031

出　　处：《河北医学》2011年第9期1161-1164,共4页Hebei Medicine

基　　金：上海市徐汇区中心医院基金资助;项目编号07c-48

摘　　要：目的:采用动态血糖监测技术(CGMS)动态比较那格列奈与阿卡波糖治疗老年人2型糖尿病患者的临床疗效。方法:将60例(大于或等于60岁)单纯饮食加运动疗法治疗不满意的2型糖尿病患者随机分为那格列奈组(n=31)及阿卡波糖组(n=29),疗程为4周。测定并比较两组患者治疗前后动态血糖监测数据,糖化血红蛋白(HbA1C),空腹及餐后2h胰岛素(FINS,P2hINS),血脂和体重指数(BMI)。结果:那格列奈组FPG下降优于阿卡波糖组,两组P值均<0.01;那格列奈对P2hBG有明显地降低作用(P<0.01);两组HbA1C均能显著降低,幅度无显著性差异(P>0.05);餐后2h血清胰岛素与治疗前比较那格列奈组升高有显著性差异(P<0.01),而阿卡波糖组明显降低(P<0.01)。结论:与阿卡波糖组相比,那格列奈组治疗后平均血糖、餐后血糖的下降幅度更为明显,晨3点血糖下降幅度较小(P均<0.05),从而使24 h血糖波动降低。而阿卡波糖可减低餐后胰岛素分泌,调节血脂,更适合肥胖患者。Objective： To compare the clinical therapeutic efficacy of the nateglinide and acarbose ontype 2 diabetic patients in the elderly by continues glucose monitoring system（GMS）.Method： Sixty pa-tients with type 2 diabetes mellitus in the elderly aged over 60 years,were randomly divided into two groupsand treated for 4 weeks either with nateglinide（n = 31） or acarbose（n =29）,respectively.The valuesof CGMS,HbA1C,FINS,P2hINS,blood-fat and BMI were periodically measured and compared beforeand after treatment.Result： The concentrations of FPG decreased both in nateglinide group and acarbosegroup respectively（P 0.01）.Nateglinide could reduce the value of P2hBG significantly（P 0.01）.The levels of HbA1C were significantly decreased in two groups,but there＇s no statistically significant differ-ence（P 0.05）.The values of P2hINS were significantly increased（P 0.01） as compared withthose in nateglinide group before treatment,but were significantly decreased（P 0.01） in acarbose groupafter treatment.Conclusion： It shows that treatment with nateglinide could decrease levels of the averageblood glucose and postprandial blood glucose more significantly（P 0.05） than the treatment with acar-bose,while the decrease of 3： 00 am blood glucose was less（P 0.05） in the former than in the latter,asa result making the daily blood glucose excursion more smoother.Acabose has the effect of reducing post-prandial insulin secretion,regulating blood-fat,thus is more suitable to obese type 2 diabetics.

关 键 词：2型糖尿病 那格列奈 阿卡波糖 动态血糖监测 餐后血糖 血脂 体重指数 

分 类 号：R587.1[医药卫生—内分泌]