西格列汀片联合地特胰岛素注射液治疗老年2型糖尿病的临床研究  

Clinical trial of sitagliptin tablets combined with insulin detemir injection in the treatment of senile type 2 diabetes mellitus

作　　者：刘玉溥[1] 曾芳馨[1] 彭祖江 田源[1] 邱麟[2] 

机构地区：[1]达州市中西医结合医院内分泌科,四川达州635000 [2]湖南师范大学附属湘南医院内分泌科,湖南衡阳421002

出　　处：《中国临床药理学杂志》2017年第15期1415-1417,共3页The Chinese Journal of Clinical Pharmacology

基　　金：湖南省医药卫生科研计划基金资助项目(B2016151)

摘　　要：目的观察西格列汀片联合地特胰岛素注射液治疗老年2型糖尿病(T2DM)的临床疗效及安全性。方法将120例老年T2DM患者随机分为对照组60例和试验组60例。2组患者均予以地特胰岛素,每晚1次,初始剂量0.2U·kg^(-1),皮下注射。对照组予以瑞格列奈0.5~2.0 mg,tid,口服;试验组予以西格列汀100 mg,qd,口服。2组患者均治疗12周。比较2组患者的临床疗效、血糖水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为95.00%(57/60例)和76.67%(46/60例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组餐后2 h血糖(2 h PG)分别为(8.20±1.14)和(9.87±1.64)mmol·L^(-1),胰岛素用量分别为(20.81±6.32)和(39.86±5.40)U·d^(-1),高血糖时间比(2 h PG>11.1 mmol·L^(-1))分别为(2.26±1.85)%和(15.93±10.76)%,低血糖时间比分别为(2.64±1.99)%和(3.60±2.84)%,血糖波动系数分别为1.50±0.26和2.47±0.39,差异均有统计学意义(均P<0.05)。2组患者的药物不良反应均为低血糖,试验组和对照组的低血糖发生率分别为1.67%和10.00%,差异有统计学意义(P<0.05)。结论西格列汀片联合地特胰岛素注射液能够有效地控制老年T2DM患者血糖水平,减少血糖波动,降低低血糖发生率。Objective To observe the clinical efficacy and safety of sitagliptin tablets combined with insulin detemir injection in the treatment of senile type 2 diabetes mellitus（ T2DM）. Methods A total of 120 elderly patients with T2 DM were randomly divided into control group and treatment group with 60 cases per group. Two groups received subcutaneous injection of insulin detemir once a night with initial dose of 0. 2 U·kg^-1.Control group received oral repaglinide 0. 5-2. 0 mg tid. Treatment group was given oral sitagliptin 100 mg qd. Two groups were treated for12 weeks. The clinical efficacy,levels of blood glucose and adverse drug reactions were compared between the two groups. Results After treatment,the total effective rates of treatment and control groups were95. 00%（ 57/60 cases） and 76. 67%（ 46/60 cases） with significant difference（ P〈0. 05）. After treatment,the main indexes in treatment and control groups were compared： the 2-hour postprandial blood glucose（ 2 h PG） were（ 8. 20 ± 1. 14）,（ 9. 87 ± 1. 64） mmol · L^-1; theinsulin dosages were（ 20. 81 ± 6. 32）,（ 39. 86 ± 5. 40） U·d-1; hyperglycemia time ratios were（ 2. 26 ± 1. 85） % and（ 15. 93 ±10. 76） % for 2 h PG 11. 1 mmol·L^-1; hypoglycemia time ratios were（ 2. 64 ±1. 99） %,（ 3. 60 ±2. 84） %;blood glucose fluctuation coefficients were 1. 50 ± 0. 26 and 2. 47 ± 0. 39,the differences were statistically significant（ all P〈0. 05）. The adverse drug reactions were based on hypoglycemia in two groups. The incidence rates of hypoglycemia were 1. 67% and 10. 00% in treatment and control groups with significant difference（ P〈0. 05）. Conclusion Sitagliptin tablets combined with insulin detemir injection can effectively control the blood glucose on the elderly patients with T2 DM,decrease the fluctuation of blood glucose,and reduce the incidence of hypoglycemia.

关 键 词：西格列汀片 地特胰岛素注射液 2型糖尿病 安全性 

分 类 号：R977.15[医药卫生—药品]