阿格列汀与瑞格列奈对2型糖尿病轻度认知功能障碍患者血糖、血脂及认知功能的影响  

Effects of alogliptin and repaglinide on blood glucose, blood lipids and cognitive function in patients with type 2 diabetes with mild cognitive impairment

作　　者：杨爱格[1] 董闪闪[1] 刘璠[1] 张趁儒[1] 冯红云[1] 王丽娜[1] 周慧敏[1] YANG Aige;DONG Shanshan;LIU Fan;ZHANG Chenru;FENG Hongyun;WANG Lina;ZHOU Huimin(The First Hospital of Hebei Medical University,Shijiazhuang 050031,Hebei,China)

机构地区：[1]河北医科大学第一医院

出　　处：《现代中西医结合杂志》2019年第28期3079-3082,3090,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：2017年河北省卫生和计划生育委员会医学科研重点课题(20170506;20170487);河北省科技计划项目(16277789D)

摘　　要：目的探讨阿格列汀和瑞格列奈对2型糖尿病轻度认知功能障碍患者血糖、血脂及认知功能的影响。方法纳入2017年2月—2018年2月于河北医科大学第一医院内分泌科就诊的2型糖尿病轻度认知功能障碍患者80例,将患者按随机数字表法分为2组,阿格列汀组40例给予阿格列汀联合二甲双胍治疗,瑞格列奈组40例给予瑞格列奈联合二甲双胍治疗,疗程均为24周。观察2组治疗前及治疗12周、24周糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2hPG)、总胆固醇(TC)、三酰甘油(TG)及蒙特利尔认知评估评分(MoCA评分,评估认知功能)变化情况,记录2组治疗结束时血糖达标率和治疗过程中低血糖及其他不良反应发生情况。结果阿格列汀组37例、瑞格列奈组38例完成研究。治疗前2组HbA1c、FPG、2hPG、TG、TC、MoCA评分比较差异均无统计学意义(P均>0.05)。治疗12周、24周后,2组TG、TC以及瑞格列奈组MoCA评分与治疗前比较差异均无统计学意义(P均>0.05),2组HbA1c、FPG、2hPG均较治疗前显著降低(P均<0.05);治疗24周后,阿格列汀组HbA1c显著低于瑞格列奈组(P<0.05),MoCA评分显著高于瑞格列奈组(P<0.05);治疗结束时,瑞格列奈组血糖达标率为71.1%(27/38),阿格列汀组血糖达标率为78.4%(29/37),2组间比较差异无统计学意义(P>0.05);瑞格列奈组低血糖发生率为31.6%(12/38),阿格列汀组低血糖发生率为10.8%(4/37),阿格列汀组低血糖发生率显著低于瑞格列奈组(P<0.05)。结论阿格列汀联合二甲双胍与瑞格列奈联合二甲双胍的降糖效果相当,对血脂均无明显影响,但阿格列汀可改善2型糖尿病轻度认知功能障碍患者认知功能,且低血糖发生率更低。Objective It is to investigate the effects of alogliptin and repaglinide on blood glucose,blood lipids and cognitive function in patients with type 2 diabetes with mild cognitive impairment.Methods Eighty patients with mild cognitive impairment of type 2 diabetes in the department of Endocrinology,the First Hospital of Hebei Medical University from February 2017 to February 2018 were enrolled divided into 2 groups according to the random number table method.Forty patients in the alogliptin group were treated with alogliptin plus metformin,and 40 patients in the repaglinide group were treated with repaglinide plus metformin for 24 weeks.The changes of glycosylated hemoglobin(HbA1c),fasting plasma glucose(FPG),postprandial 2h blood glucose(2hPG),total cholesterol(TC),triglyceride(TG)and Montreal cognitive assessment score(MoCA score for assessment of cognitive function)were observed before treatment and 12 weeks and 24 weeks after treatment,the blood glucose compliance rate at the end of treatment and the occurrence of hypoglycemia and other adverse reactions during the treatment were evaluated.Results There were 37 patients in the alogliptin group and 38 patients in the repaglinide group who completed the study.There was no significant differences in the scores of HbA1c,FPG,2hPG,TG,TC and MoCA between the two groups before treatment(P>0.05).After 12 weeks and 24 weeks of treatment,there was no significant difference in TG,TC in the two groups and MoCA scores in the repaglinide group compared with those before treatment(P>0.05),but HbA1c,FPG and 2hPG were significantly higher than those before treatment(P<0.05);after 24 weeks of treatment,HbA1c was significantly lower and the MoCA scores were significantly higher in the alogliptin group than that in the repaglinide group(P<0.05).At the end of treatment,the blood glucose compliance rate was 71.1%(27/38)in the repaglinide group and 78.4%(29/37)in the alogliptin group,there was no significant difference between the two groups(P>0.05);the incidence of hypoglycemia was

关 键 词：2型糖尿病 阿格列汀 瑞格列奈 血糖 认知功能 

分 类 号：R587.2[医药卫生—内分泌]