Graves病合并2型糖尿病患者二肽基肽酶-4水平的变化及使用抑制剂治疗的效果  

Clinical analysis of dipeptidyl peptidase-4 level and treatment effect of DPP-4 inhibitor on Graves disease combined with type 2 diabetes mellitus

作　　者：武仅 张莹[1] 吴文迅[1] Wu Jin;Zhang Ying;Wu Wenxu(Department of Endocrinology and Metabolism,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院内分泌代谢科,450000

出　　处：《中国实用医刊》2019年第18期12-15,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨Graves病(GD)合并2型糖尿病(T2DM)患者二肽基肽酶-4(DPP-4)的水平变化及使用DPP-4抑制剂(DPP-4I)治疗的效果。方法收集2017年6月至2018年8月郑州大学第一附属医院内分泌科门诊及住院的GD患者40例(A组)、GD合并T2DM患者120例(B组)、T2DM患者40例(C组),正常对照者40例(D组),分析四组间DPP-4水平的差异;B组患者在给予抗甲状腺药物(ATD)的基础上,分别给予DPP-4I西格列汀(B1组)、二甲双胍(B2组)、西格列汀+二甲双胍(B3组)方案治疗,随访12周,比较治疗前后患者甲状腺功能、空腹血糖(FBG)、糖化血红蛋白(HbA1c)变化。结果B组DPP-4活性高于A、C、D组(P<0.05);B1、B3组治疗后12周(FBG)、HbA1c下降,差异有统计学意义(P<0.05);治疗后12周,B组三亚组间甲状腺功能比较,差异未见统计学意义(P>0.05)。结论DPP-4在GD合并T2DM患者中水平增加,ATD联合DPP-4I有利于提高两种疾病同时存在时的治疗效果,延缓疾病进展。Objective To investigate the level of dipeptidyl peptidase-4(DPP-4) in patients in Graves disease (GD) combined with type 2 diabetes melliyus(T2DM)and treatment effects of DPP-4 inhibitor (DPP-4I) on the patients . Methods The clinical data from outpatients and inpatients who were divided into 40 patients only with GD (group A), 120 patients with GD combined with T2DM (group B), 40 patients only with T2DM (group C), 40 healthy individuals (group D) were collected from the Department of Endocrinology of the First Affiliated Hospital of Zhengzhou University from June 2017 to August 2018. The differences in DPP-4 activity among the 4 groups were analyzed. The subjects of group B were randomly grouped into sitagliptin treatment group(B1), metformin treatment group (B2) and sitagliptin combined with metformin group (B3). And the three subgroups were treated with anti-thyroid drug (ATD), additionally. The patients were followed up for twelve weeks. The thyroid function, fasting blood glucose (FBG) and glycosylated hemoglobin (HbA1c) before and after treatment were compared. Results The level of DPP-4 in B group was higher than that in group A, group C and group D (P<0.05). After 12 weeks of treatment, FBG and HbA1c decreased significantly in group B1 and group B3, and the difference was significant (P<0.05). After 12 weeks of treatment, thyroid function was compared among three subgroups in group B, however, there was no significant difference (P>0.05). Conclusions DPP-4 activity increases in patients with GD and T2DM. ATD combined with DPP-4I is more beneficial to improving the therapeutic effect, and it can impede the progression of the disease.

关 键 词：二肽基肽酶-4 二肽基肽酶-4抑制剂 GRAVES病 2型糖尿病 

分 类 号：R587.1[医药卫生—内分泌] R581.1[医药卫生—内科学]