西格列汀联合大剂量胰岛素治疗2型糖尿病的临床观察  

Effects of sitagliptin combined with high-dose insulin on type 2 diabetes mellitus

作　　者：裴蕾蕾 孙中华[1] 李哲[1] 赵文萍[1] 

机构地区：[1]吉林大学第一医院内分泌科,吉林长春130021

出　　处：《山东大学学报（医学版）》2015年第2期39-42,共4页Journal of Shandong University:Health Sciences

摘　　要：目的观察大剂量胰岛素联合西格列汀治疗2型糖尿病的临床疗效和安全性。方法选取2012年9月至2013年9月确诊2型糖尿病并需大剂量胰岛素(>60 U/d)治疗的患者60例,随机分为两组:胰岛素+西格列汀组(胰岛素>60 U/d,西格列汀100 mg,1次/d)和胰岛素组(胰岛素>60 U/d),每组30例。治疗3个月,根据血糖情况调整剂量。比较治疗前及治疗3个月后血糖、血脂等指标的变化及两组间主要指标的变化情况。结果治疗3个月后,两组空腹血糖(FBG)、餐后2 h血糖(2h PG)、糖化血红蛋白(Hb A1c)较治疗前有所下降(P均<0.05),胰岛素组胰岛素用量及体质量指数(BMI)较治疗前显著增加(P<0.05),胰岛素+西格列汀组治疗后胰岛素用量减少,BMI、甘油三酯(TG)降低(P<0.05)。胰岛素组与胰岛素+西格列汀组胰岛素用量[(70.32±6.56)vs(59.26±5.03)U]、TG[(2.64±1.32)vs(2.21±0.92)mmol/L]、BMI(27.24±2.36 vs 26.25±1.92)差异具有统计学意义(P均<0.01)。胰岛素组与胰岛素+西格列汀组分别有8例(26.70%)和1例(3.30%)患者出现低血糖。结论大剂量胰岛素(>60 U/d)联合西格列汀(100 mg,1次/d)治疗2型糖尿病有利于患者血糖、血脂、BM I的控制,同时可以减少胰岛素用量,降低低血糖发生率。Objective To observe the efficacy and safety of sitagliptin combined with high-dose insulin on type 2 diabe-tes mellitus.Methods Sixty patients with type 2 diabetes who needed high-dose insulin（greater than 60 U/d）treat-ment,diagnosed during Sep.2012 to Sep.2013 in our hospital,were divided into insulin combined with sitagliptin group（insulin〉60 U/d and sitagliptin 100 mg 1 time/d）and insulin group （insulin〉60 U/d ）,with 30 patients in each group.After 3-month treatment,the levels of blood glucose,serum lipid and other indicators were compared between the two groups.Results After 3-month treatment,fasting blood glucose（FBG）,2-hour postprandial glucose （2hPG）,glycosylated hemoglobin（HbA1c）decreased significantly （all P 〈0.05）in both group.The insulin dosage, body mass index （BMI）increased significantly （P 〈0.05）after treatment in insulin group,while the insulin dosage, BMI and triglyceride（TG）reduced significantly （P 〈0.05）after treatment in insulin combined with sitagliptin group. Compared with insulin group,the patients in insulin combined with sitagliptin group showed lower insulin dosage [（70.32 ±6.56）vs （59.26 ±5.03）U],TG[（2.64 ±1.32）vs （2.21 ±0.92）mmol/L]and BMI （27.24 ±2.36 vs 26.25 ±1.92）（all P 〈0.01）.One patient（3.30%）in insulin combined with sitagliptin group and 8 patients （26.70%） in insulin group occurred hypoglycemia.Conclusion Sitagliptin（100 mg,1 time/d）combined with high-dose（〉60 U/d）＆nbsp;insulin in the therapy of patients with type 2 diabetes mellitus is beneficial for controlling the indicators,such as blood glucose,serum lipid,BMI as well as reducing the dosage of insulin and occurrence of hypoglycemia.

关 键 词：2 型糖尿病 西格列汀 大剂量胰岛素 低血糖 

分 类 号：R587.1[医药卫生—内分泌]