2型糖尿病轻度认知功能障碍患者应用阿格列汀治疗的有效性及安全性  

Efficacy and safety of alogliptin for patients with type 2 diabetic mild cognitive impairment

作　　者：王静[1] 刘璠[2] 董闪闪[2] 冯红云[2] 杨爱格[2] 周慧敏[2] WANG Jing;LIU Fan;DONG Shan-shan;FENG Hong-yun;YANG Ai-ge;ZHOU Hui-min(The School Hospital,Shijiazhuang Information Engineering Vocational College,Hebei Province, Shijiazhuang 050035,China;Department of Endocrinology,the First Hospital of Hebei Medical University,Shijiazhuang 050031,China)

机构地区：[1]石家庄信息工程职业学院校医院,河北石家庄050035 [2]河北医科大学第一医院内分泌科,河北石家庄050031

出　　处：《河北医科大学学报》2019年第1期33-37,共5页Journal of Hebei Medical University

基　　金：河北省科技计划项目(16277789D);河北省医学科学研究重点课题(20170506)

摘　　要：目的探讨2型糖尿病轻度认知功能障碍(mild cognitive impairment,MCI)患者在二甲双胍基础上加用胰岛素促泌剂、α-糖苷酶抑制剂、二肽基肽酶(dipeptidyl peptidase-4,DPP-4)抑制剂治疗有效性、安全性的区别。方法将2型糖尿病MCI患者120例随机分为阿格列汀组、阿卡波糖组和瑞格列奈组各40例。阿格列汀组加用阿格列汀,阿卡波糖组加用阿卡波糖,瑞格列奈组加用瑞格列奈。疗程24周。测定糖化血红蛋白(hemoglobin A1c,HbA1c)、空腹血糖(fasting plasma glucose,FPG)、餐后2h血糖(2hpostprandial blod glucose,2hPBG)、总胆固醇(total cholesterol,TC)、三酰甘油(triglycerides,TG),记录所有低血糖事件、胃肠道反应及HbA1c达标率。结果与治疗前比较,3组HbA1c、FPG、2hPBG均显著下降(P<0.01),TG、TC无显著变化(P>0.05)。同一时间点各组间HbA1c、FPG、2hPBG、TG和TC差异均无统计学意义(P>0.05)。治疗结束时,阿格列汀组血糖达标率最高74.36%(χ2=6.496,P<0.01),胃肠道反应发生率最低0.00%(χ2=37.853,P<0.01),低血糖发生率最低2.56%(χ2=16.955,P<0.01)。结论阿格列汀治疗2型糖尿病MCI患者,降糖效果不劣于阿卡波糖和瑞格列奈,低血糖发生率、胃肠道反应发生率更低。Objective To explore the efficacy and safety of alogliptin,acarbose and repaglinide in patients with type2diabetic mild cognitive impairment inadequately controlled by metformin.Methods The120patients with type2diabetic mild cognitive impairment inadequately controlled by metformin were randomly divided into thealogliptin group(n=40),theacarbose group(n=40)and therepaglinidegroup(n=40).During the 22-week treatment period,patients in the alogliptin group were given metformin and alogliptin,patients in the acarbose group were given metformin and acarbose and patients in the repaglinide group were given metformin and repaglinide.At week0,12and24of the clinic trial,hemoglobin A1c(HbA1c),fasting plasma glucose(FPG),2h postprandial blood glucose(2hPBG),triglycerides(TG),total cholesterol(TC)were measured,all hypoglycemic events and gastrointestinal reaction during the trial recorded and the percentage of patients achieving HbA1c target of<7%were recorded.Results After the treatment,HbA1c,FPG and2hPBG in three groups lowered obviously.Comparing with those before treatment,the differences were significant(P<0.01),while there were no significant changes among the three groups in TG and TC(P>0.05).There were no significant difference among the three groups in HbA1c,FPG,2hPBG,TG and TC(P>0.05).After the treatment,the percentage of patients achieving HbA1c target of<7%was highest(74.36%,χ^2=6.496,P<0.01),the incidence of hypoglycemia(2.56%,χ^2=16.955,P<0.01)and gastrointestinal reaction(0.00%,χ^2=37.853,P<0.01)in the alogliptin group was lowest among the three groups.Conclusion The efficacy of alogliptin was not inferior to that of acarbose and regrainidein patients with type2diabetic mild cognitive impairment inadequately controlled by metformin,while compared with them,the incidences of hypoglycemia and gastrointestinal reaction were lowest in those treated by alogliptin.

关 键 词：糖尿病 2型 轻度认知障碍 阿格列汀 

分 类 号：R587.1[医药卫生—内分泌] R741[医药卫生—内科学]