肥胖型2型糖尿病二甲双胍单药治疗不理想者分别加用西格列汀与吡格列酮的疗效对比  

Efficacy comparison between sitagliptin and pioglitazone in the treatment of the obesity type 2 diabetes mellitus patients unresponsive to treatment with metformin

作　　者：闫晓洁 王丽娜 温小明 YAN Xiao-jie;WANG Li-na;WEN Xiao-ming(Department of Endocrinology,Shenzhen Hospital,Southern Medical University,Shenzhen Guangdong 518000,China)

机构地区：[1]南方医科大学深圳医院内分泌科,广东深圳518000

出　　处：《蚌埠医学院学报》2018年第4期503-506,共4页Journal of Bengbu Medical College

摘　　要：目的:探讨肥胖型2型糖尿病二甲双胍单药治疗不理想者分别加用西格列汀与吡格列酮治疗的临床效果及安全性。方法:选取单用二甲双胍治疗不理想的肥胖型2型糖尿病病人98例为研究对象,按随机数字表法分为A、B 2组,每组49例,A组加用西格列汀治疗,B组加用吡格列酮治疗,观察2组病人血糖、胰岛素、体质量指数(BMI)、血脂、胰岛素抵抗及不良反应发生情况。结果:治疗前2组病人血糖、胰岛素、BMI及血脂水平及胰岛素抵抗指标差异均无统计学意义(P>0.05),治疗后各项指标同治疗前比较均有改善(P<0.05);治疗后2组空腹血糖、血脂、胰岛素水平差异均无统计学意义(P>0.05),A组餐后2 h血糖及BMI水平均低于B组(P<0.05);A、B 2组病人用药后不良反应发生率分别为10.20%、14.29%,差异无统计学意义(P>0.05),均未出现严重不良反应。结论:二甲双胍分别联合西格列汀与吡格列酮治疗肥胖型2型糖尿病,均可获得理想效果,且具有较高安全性,但西格列汀在餐后血糖及体质量控制方面效果优于吡格列酮。Objective： To compare the effects and safety between sitagliptin and pioglitazone in the treatment of the obesity type 2 diabetes mellitus patients unresponsive to treatment with metformin.Methods： Ninety-eight obesity type 2 diabetes mellitus patients unresponsive to treatment with metformin were divided into the group A and group B according to random number table method（49 cases each group）.The group A and group B were additionally treated with sitagliptin and pioglitazone,respectively.The levels of blood glucose,insulin,body mass index（BMI）,blood lipid and insulin resistance index,and adverse reactions between two groups were compared. Results： Before treatment,the differences of the levels of blood glucose,insulin,BMI,blood lipid and insulin resistance between two groups were not statistically significant（ P 〉0.05）,and all indexes in two groups were significantly improved after treatment.After treatment,the differences of the levels of fasting blood glucose,insulin and blood lipid between two groups were not statistically significant（ P 〉0.05）,and the levels of postprandial 2 h blood glucose and BMI in group A were significantly lower than those in group B（ P 〈0.05）.The incidence rates of adverse reactions in group A and group B were 10.20% and 14.29%,respectively,the difference of which was not statistically significant（ P 〉0.05）,and there were not severe adverse reactions in two groups.Conclusions： The effects of obesity type 2 diabetes mellitus treated with metformin combined with sitagliptin or pioglitazone are ideal and safe,but the effects of sitagliptin on postprandial blood glucose and body weight control are better than those of pioglitazone.

关 键 词：2型糖尿病 二甲双胍 吡格列酮 西格列汀 

分 类 号：R587.1[医药卫生—内分泌]