超重和肥胖2型糖尿病伴微量白蛋白尿患者使用达格列净或沙格列汀控制血糖疗效和安全性的观察  

Efficacy and safety of Dapagliflozin versus Saxagliptin in overweight/obese type 2 diabetes mellitus compli-cated with microalbuminuria

作　　者：范晓霞[1] 姚勇利[1] 胡耀嘉 刘学良 王淑琼[1] FAN Xiaoxia;YAO Yongli;HU Yaojia(Department of Endocrinology,Qinghai People's Hospital,Xining 810007,China)

机构地区：[1]青海省人民医院内分泌二科,西宁810007 [2]兰州大学第一临床医学院 [3]青海省食品药品监督管理局食品药品审评中心

出　　处：《中国糖尿病杂志》2020年第2期85-88,共4页Chinese Journal of Diabetes

基　　金：青海省卫生计生课题(2017-WJzdx-18)。

摘　　要：目的观察达格列净或沙格列汀在超重和肥胖T2DM伴微量白蛋白尿(UAlb)患者中应用的疗效和安全性.方法选取2017年10月至2018年10月于青海省人民医院内分泌科住院的BMI>24 kg/m2的T2DM伴UAlb患者125例,随机分为达格列净组(Dap)58例,沙格列汀组(Sax)67例.两组均联合二甲双胍治疗24周,比较各组BMI、SBP、DBP、FPG、2 hPG、血肌酐(Scr)、血尿酸(SUA)、HbA1c、UACR等,记录不良反应.结果两组治疗前FPG、2 hPG、HbA1c、Scr、SUA、UACR比较,差异无统计学意义(P>0.05),治疗后FPG、2 hPG、HbA1c、Scr、SUA、UACR较治疗前降低(P<0.05).Dap组治疗前后BMI、SBP、DBP、HbA1c比较,差异有统计学意义(P<0.05);Sax组治疗前后FPG、2 hPG、HbA1c比较,差异有统计学意义(P<0.05),BMI、SBP、DBP差异无统计学意义(P>0.05).Dap组治疗后BMI、SBP、DBP、FPG、2 hPG、HbA1c、Scr、SUA、UACR低于Sax组(P<0.05).结论超重和肥胖T2DM伴UAlb患者口服达格列净或沙格列汀均能有效控制其血糖水平,安全性较好.Objective To compare the efficacy nnd safety between Dapagliflozin and Saxagliptin in overweight/obese type 2 diabetes(T2DM)patients complicated with microalbuminuria(UAlb).Methods A total of 125 T2DM patients with UAlb admitted in our department from October 2017 to October 2018 were divided into two treatment groups:Dapagliflozin group(Dap,n=58),Saxagliptin group(Sax,n=67).Both groups were simultaneously treated with Metformin for 24 weeks.The changes of BMI.SBP,DBP,FPG,2 hPG,HbA1C,Scr,SUA,UACR,renal function and adverse events were compared between the two groups.Results There was no significant di f fere nee in the level of FPG,2 hPG,HbA1C,Scr,SUA and UACR between Dap and Sax group before treatment.BMI,SBP,DBP and HbA1c were significantly decreased in Dag group after treatment(P<0.05).FPG,2 hPG and HbA1C were statistically decreased in Sax group(P<0.05).The levels of FPG,HbA1c,SBP.DBP,BMI,Scr,SUA and UACR were significantly lower in Dap group than those in Sax group(P<0.05).Conclusion For overweight/obese T2DM patients with UAlb,both Dapagliflozin and Saxagliptin can effectively control the blood glucose with good safety.

关 键 词：达格列净 沙格列汀 超重和肥胖 糖尿病 2型 微量白蛋白尿 

分 类 号：R587.2[医药卫生—内分泌] R696.2[医药卫生—内科学]