2型糖尿病患者应用西格列汀的抗动脉粥样硬化效应  

Antiatherosclerosis effect of sitagliptin in patients with type 2 diabetes mellitus

作　　者：郭云飞[1] 卢清玉[1] 韩萍[1] 张伶[1] 徐冬梅[1] 杨静文[1] 张福春[2] 

机构地区：[1]北京市海淀医院心内科,北京100080 [2]北京大学第三医院老年内科,北京100191

出　　处：《临床荟萃》2016年第9期975-977,982,共4页Clinical Focus

摘　　要：目的探讨口服降糖药物二肽基肽酶4(DPP-4)抑制剂西格列汀对接受胰岛素治疗的2型糖尿病患者颈动脉内膜中层厚度(IMT)的影响。方法本研究是一个前瞻性、随机、平行对照研究。接受胰岛素治疗后血糖控制不良的2型糖尿病患者172例,分为西格列汀治疗组84例和对照组88例,通过颈动脉超声评价治疗后12个月平均IMT变化。结果随访12个月后,西格列汀组IMT较基线明显降低,而对照组无明显变化。西格列汀组IMT较对照组明显降低(P<0.05)。同时,西格列汀组降糖效应优于对照组(P<0.05),而且低血糖和体质量增加等不良事件未见增多。结论对于接受胰岛素治疗的2型糖尿病患者,加用西格列汀治疗降低血糖同时可抑制颈动脉IMT进展。Objective To explore the effect of sitagliptin,a dipeptidyl peptidase 4inhibitor,on carotid intimamedia thickness（IMT）in insulin-treated patients with type 2diabetes mellitus（T2DM）.Methods This prospective,randomized,parallel group and comparative study included 172insulin-treated patients with T2 DM who were randomly allocated to either the sitagliptin group（n=84）or the control group（n=88）.The primary outcomes were changes in mean IMT of the carotid artery measured by echography at the end of a 12-months′treatment.Results Changes in the mean IMT of the carotid arteries were significantly greater after sitagliptin treatment compared with conventional treatment（P〈0.05）.After follow-up of 12 months,sitagliptin,but not conventional treatment,significantly reduced the mean IMT of carotid arteries relative to the baseline.Sitagliptin had a more potent glucose-lowering effect compared with the conventional treatment（P〈0.05）,without increasing hypoglycemic episodes or body mass.Conclusion Sitagliptin attenuated the progression of carotid IMT in insulin-treated T2 DM patients with glucoselowering effect.

关 键 词：糖尿病 2型 动脉粥样硬化 二肽基肽酶Ⅳ抑制剂 颈动脉内膜中膜厚度 

分 类 号：R587.1[医药卫生—内分泌]