不同病程超重T2DM患者加用沙格列汀治疗后临床疗效及安全性观察  

Clinical efficacy and safety observation of saxagliptin in the treatment of different duration of type 2 diabetes with overweight

作　　者：张萍[1] 潘天荣[1] 杜益君[1] 钟兴[1] Zhang Ping;Pan Tianrong;Du Yijun(Dept of Endocrinology,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601)

机构地区：[1]安徽医科大学第二附属医院内分泌科,合肥230601

出　　处：《安徽医科大学学报》2018年第9期1457-1460,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省2015年公益性技术应用研究联动计划项目(编号15011d04042)

摘　　要：目的评价沙格列汀治疗不同病程阶段超重2型糖尿病(T2DM)的临床疗效及安全性。方法选取70例二甲双胍治疗血糖不达标的超重T2DM患者,根据病程分为短病程组(病程≤3年)和长病程组(病程>3年)。两组均加用沙格列汀持续治疗24周,观察并比较两组的临床疗效及安全性。结果治疗后,两组空腹血糖(FBG)、餐后2 h血糖(2h PG)、糖基化血红蛋白(Hb A1c)、胰岛素抵抗指数(HOMA-IR)、体重指数(BMI)、血三酰甘油(TG)、收缩压(SBP)均较治疗前明显下降,胰岛β细胞功能指数(HOMA-β)升高,差异有统计学意义(均P<0.05)。与长病程组相比,短病程组FBG、2h PG、Hb A1c降低更明显,HOMA-β升高更为显著(P<0.01)。短病程组低血糖发生率高于长病程组(P<0.05),但两组均无严重低血糖及胃肠道不良反应发生。结论沙格列汀联合二甲双胍治疗不同病程超重T2DM患者均可明显降低血糖、改善胰岛β细胞功能,并能减轻体重;早期联合使用沙格列汀,血糖下降及胰岛β细胞功能的改善更为显著。Objective To assess the clinical efficacy and safety of saxagliptin in the treatment for different course of type 2 diabetes（ T2 DM） with overweight. Methods 70 cases of obese or overweight T2 DM patients in poorly controlled with oral metformin were divided into two groups based on the duration of T2 DM： hort duration group（ ≤3 years） and long duration group（ 3 years）. The two groups were added saxagliptin treatment on the basis of metformin orally treatment. After 24 weeks treatment,clinical efficacy and safety between two groups were compared.Results After treatment,fasting blood glucose（ FBG）,2 h postprandial blood glucose（ 2 h PG）,glycated hemoglobin（ Hb A1 c）,triglyceride（ TG）,systolic blood pressure（ SBP）,body mass index（ BMI）,homeostatic model insulin resistance index（ HOMA-IR） of two groups decre-ased significantly,while homeostatic model islet β-cell function index（ HOMA-β） was increased（ P〈0. 05）. FBG,2 h PG,Hb A1 c were decreased in short duration group compared with long duration group,while HOMA-β was increased（ P〈0. 01）. The hypoglycemia in short course group was higher than that in long course group（ P〈0. 05）. No severe hypoglycemia and gastrointestinal adverse reactions occurred in both groups. Conclusion Saxagliptin combined with metformin can significantly reduce blood glucose,improve islet β-cell function,and reduce body weight in patients with overweight T2 DM. The efficacy was more significant in early stage of T2 DM patients.

关 键 词：2型糖尿病 沙格列汀 超重 病程 

分 类 号：R587[医药卫生—内分泌]