加药联合阿格列汀/格列美脲治疗二甲双胍单药控制不佳2型糖尿病患者的效果对比研究  

Comparison on Addingalogliptin or Glimepiride in poorly controlled in patients with type 2 diabetes with oral Metformin

作　　者：钟树妹[1] 张四青[1] 

机构地区：[1]江西省赣州市人民医院内分泌科,江西赣州341000

出　　处：《中国当代医药》2017年第32期121-123,共3页China Modern Medicine

基　　金：江西省赣州市指导性科技计划项目(GZ2015ZSF178)

摘　　要：目的比较二甲双胍单药治疗血糖控制不佳的2型糖尿病(T2DM)患者加药联合阿格列汀或格列美脲的临床疗效。方法选择2014年3月~2016年3月在我院内分泌科治疗二甲双胍单药治疗血糖控制不佳的T2DM患者60例,随机分为A、B组两组,每组30例。A组患者给予二甲双胍联合阿格列汀,B组患者给予二甲双胍联合格列美脲治疗,比较观察24周后患者体重指数(BMI)、胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)、空腹血糖(FBG)、餐后2 h血糖(2 h PG)、低血糖及胰岛素抵抗指数(HOMA-IR)的变化情况。结果治疗24周后,两组患者的FBG、2 h PG、Hb A1c较治疗前显著下降,差异有统计学意义(P<0.05)。两组患者的HOMA-IR较治疗前也显著下降,组间差异无统计学意义(P>0.05)。A组患者的TC、TG、LDL-C及BMI较治疗前显著下降(P<0.05),HDL-C显著升高,差异有统计学意义(P<0.05);而B组患者治疗前后差异无统计学意义(P>0.05)。A组无低血糖发生,B组低血糖发生2例。结论对二甲双胍单药治疗血糖控制不佳的T2DM患者加药联合阿格列汀与格列美脲治疗均能显著改善患者的血糖、体重及胰岛素抵抗,可以根据患者的病情而采用不同的治疗方案。Objective To compare the efficacy between Alogliptin and Glimepiride in poorly controlledin patients with type 2 diabetes（T2DM） with oral Metformin.Methods 60 in poorly controlled in patients with T2DM with oral Metformin in our hospital from March 2014 to March 2016 were randomized into two groups of receiving Alogliptin with Metformin （A group,30 cases） and Glimepiride with Metformin （B group,30cases） for 24 weeks.The changes of BMI,TC, G,HDL-C, LDL-C,FBG,HOMA-IR and Hypoglycemic were observed.Results After 24 weeks treatment,the FBG,2 h PG and HbAlc were significantly reduced compared with their pre-treatment （P〈0.05） in two groups,and there was significant difference between the two groups （P〈0.05）.The HOMA-IR of the two groups were decreased significantly before treat- ment,but there was no significant difference between the groups （P〉0.05）.The TC,TG, LDL-C and BMI of A group as bviously decreased and HDL-C was significantly increased than before treatment （P〈0.05）,there was no significant difference in B group.There was no hypoglycemia occurs in A group,but two case was happened in B group.Conclusion Combined with Alogliptinor Glimepiridein poorly controlledin patients with T2DM with oral Metformin can significantly improve the patient＇s blood glucose,body weight and insulin resistance.Different treatment options can be used depend- ing on the patient＇s differences.

关 键 词：二甲双胍 阿格列汀 格列美脲 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌]