西格列汀联合格列美脲治疗2型糖尿病的效果及对患者血糖波动的影响  

Efficacy of sitagliptin combined with glimepiride in the treatment of type 2 diabetes mellitus and its effect on blood glucose variability

作　　者：邢莉[1] 张凯[2] Xing Li;Zhang Kai(Department of Endocrinology,Heping Hospital Affiliated to Changzhi Medical College,Changzhi 046000,China;Pathological Staff Room,Changzhi Medical College,Changzhi 046000,China)

机构地区：[1]长治医学院附属和平医院内分泌科,山西省046000 [2]长治医学院病理教研室,山西省046000

出　　处：《中国实用医刊》2020年第13期99-102,共4页Chinese Journal of Practical Medicine

摘　　要：目的研究西格列汀联合格列美脲治疗2型糖尿病(T2DM)患者的效果及对患者血糖波动的影响。方法抽取2017年10月至2019年10月长治医学院附属和平医院收治的T2DM患者96例,采用随机数字表法将其分为研究组和对照组,每组48例。对照组患者口服磷酸西格列汀+阿卡波糖,研究组患者口服磷酸西格列汀+格列美脲,持续治疗3个月后,观察比较两组血糖指标[空腹血糖(FBG)、糖化血红蛋白(HbA1c)、餐后2 h(2 h PG)、平均血糖波动(MAGE)]、胰岛β细胞功能指数(HOMA-β)、胰岛素抵抗指数(HOMA-IR)、3-硝基酪氨酸(3-NT)、C-反应蛋白(CRP)及不良反应发生情况。结果治疗前,两组FBG、HbA1c、2 h PG、MAGE、3-NT、CRP、HOMA-IR、HOMA-β水平比较差异未见统计学意义(P>0.05)。治疗后,两组FBG、HbA1c、2 h PG、MAGE、3-NT、CRP、HOMA-IR水平较治疗前下降(P<0.05),两组HOMA-β水平较治疗前上升(P<0.05),且研究组FBG、HbA1c、2 h PG、MAGE水平低于对照组(P<0.05),HOMA-β水平高于对照组(P<0.05)。对照组总不良反应发生率为6.25%(3/48),研究组为10.42%(5/48),两组比较差异未见统计学意义(P>0.05)。结论西格列汀联合格列美脲治疗T2DM效果确切,能有效控制患者血糖水平,降低血糖波动幅度。Objective To investigate the efficacy of sitagliptin combined with glimepiride in the treatment of type 2 diabetes mellitus (T2DM), and its effects on blood glucose variability.Methods A total of 96 T2DM patients hospitalized in Heping Hospital Affiliated to Changzhi Medical College from October 2017 to October 2019 were selected and divided into control group and study group by random number table methods, with 48 cases in each group. Control group received siglitine phosphate + acarbose orally, while study group received siglitine phosphate + glimepirea orally. After 3 months of continuous treatment, various indexes were compared between groups, including fasting plasma glucose (FBG), glycated hemoglobin (HbA1c), 2 hours postprandial blood glucose (2 h PG), mean amplitude of glycemic excursions (MAGE), homeostasis model assessment-β (HOMA-β), homeostasis model assessment-insulin resistance (HOMA-IR), 3-nitrotyrosine (3-NT), C-reactive protein (CRP) and adverse reaction rate.Results Levels of FBG, HbA1c, 2 h PG, MAGE, 3-NT, CRP, HOMA-IR and HOMA-β had no difference between the two groups before treatment (P>0.05). After treatment, the levels of FBG, HbA1c, 2 h PG, MAGE, 3-NT, CRP and HOMA-IR decreased in both groups (P<0.05), and the levels of HOMA-β increased in both groups (P<0.05);and the levels of FBG, HbA1c, 2 h PG and MAGE in the study group were significantly lower than those in the control group (P<0.05), the level of HOMA-β was higher than that in the control group (P<0.05). The total adverse reaction rate was 6.25% (3/48) in the control group, and 10.42% (5/48) in the study group, however, there was no significant difference between the two groups (P>0.05).Conclusions Sitagliptin combined with glimepiride for T2DM can effectively control patients’ blood glucose levels and reduce blood glucose fluctuations.

关 键 词：2型糖尿病 西格列汀 格列美脲 效果 血糖波动 

分 类 号：R587.1[医药卫生—内分泌]