经典二联口服降糖药基础上加用西格列汀的临床疗效观察  

作　　者：余筱燕[1] 陈建娥 韩锡顺 何丽 毛玉山[1] 

机构地区：[1]宁波大学医学院附属医院,315020 [2]浙江省宁波市江北区白沙社区卫生服务中心,315020

出　　处：《浙江临床医学》2020年第5期663-665,共3页Zhejiang Clinical Medical Journal

基　　金：浙江省医药卫生科技计划基金资助项目(2018ZH029)。

摘　　要：目的观察西格列汀对经典二联降糖药控制不佳患者的降糖效果与安全性。方法选择二甲双胍片分别联合格列齐特缓释片(A组)、格列美脲片(B组)、瑞格列奈片(C组)和阿卡波糖片(D组)治疗血糖控制不佳的2型糖尿病患者,各100例,加用西格列汀片治疗。观察24周后四组空腹血糖(FPG)、餐后2h血糖(2hPG)、餐后血糖波动幅度(PPGE)、糖化血红蛋白(HbAlc)、体质指数(BMI)、血脂等方面的变化及安全性。结果四组患者经西格列汀干预24周后,FPG、2hPG、PPGE、HbAlc及低密度脂蛋白(LDL-C)指标均显著下降,与治疗前差异有统计学意义(P<0.05)。D组患者的HbAlc达标率比例高于其他各组,差异有统计学意义(P<0.05)。C组患者HbAlc达标率比例低于其他各组,低血糖发生率高于其他各组,差异有统计学意义(P<0.05)。四组不良反应发生率均较低,组间差异无统计学意义(P>0.05)。结论加用西格列汀治疗可显著降低经典二联降糖药控制不佳患者的血糖与血脂水平,提高HbAlc达标率,安全性较好,值得在临床上推广应用。Objective To observe the hypoglycemic effect and safety of sitagliptin on the basis of classical two oral hypoglycemic agents in patients with poor glycemic control.Method Type 2 diabetes mellitus patients with poor glycemic control were treated with metformin tablets combined with gliclazide sustained-release tablets(A group),glimepiride tablets(B group),repaglinide(C group)and acarbose tablets(D group),respectively.One hundred(100)patients were enrolled in each group,and were treated with sitagliptin tablets additionally.The changes of fasting blood glucose(FPG),postprandial 2-hour blood glucose(2hPG),postprandial blood glucose fluctuation(PPGE),glycosylated hemoglobin(HbAlc),body mass index(BMI),and blood lipids as well as safety were observed after 24 weeks of treatment.Result After 24 weeks treatment of sitagliptin,FPG,2hPG,PPGE,HbAlc and LDL-C were significantly decreased in the four groups(P<0.05).The proportion of patients with achieved rate and better control of HbAlc in group D were higher than those in other groups,and the difference was statistically significant(P<0.05).The HbAlc achieved rate and the proportion of patients with better HbAlc control in group C were lower than those in other groups,and the incidence of hypoglycemia was higher than other groups(P<0.05).The incidence of adverse reactions in the 4 groups was low,and the difference between the groups was not statistically significant(P>0.05).Conclusion The additional treatment of sitagliptin on the basis of classical two oral hypoglycemic agents can significantly reduce blood glucose and blood lipids in patients with poor glycemic control,improve HbAlc achieved rate,and have good safety.It is worthy of clinical popularizing and application.

关 键 词：西格列汀 2型糖尿病 疗效 安全性 

分 类 号：R58[医药卫生—内分泌]