二甲双胍联合西格列汀治疗2型糖尿病患者的临床效果  

Clinical effect of Metformin combined with Sitagliptin in the treatment of patients with type 2 diabetes

作　　者：李琼 范军秀 彭卫 庞东岳 胡晶晶 张莉芝 LI Qiong;FAN Jun-xiu;PENG Wei;PANG Dong-yue;HU Jing-jing;ZHANG Li-zhi(Department of Medical Laboratory,Ji′an Hospital,Shanghai Oriental Hospital,Jiangxi Province,Ji′an 343000,China;Department of Endocrinology,Jiangqiao Hospital in Jiading District,Jiading Branch of the First People′s Hospital of Shanghai City,Shanghai 201803,China)

机构地区：[1]上海市东方医院吉安医院医学检验科,江西吉安343000 [2]上海市嘉定区江桥医院上海市第一人民医院嘉定分院内分泌科,上海201803

出　　处：《中国当代医药》2021年第17期59-63,F0003,F0004,共7页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(20204850)。

摘　　要：目的探讨二甲双胍联合西格列汀治疗2型糖尿病患者的临床效果。方法选取2017年1月~2020年7月在上海市东方医院就诊的单用二甲双胍降糖效果不佳的105例2型糖尿病患者作为研究对象,其中有5例脱落,最终入组100例,采用随机数字表法将其分为A组(30例),B组(35例)和C组(35例)。A组患者继续采用二甲双胍治疗,B组患者采用二甲双胍联合阿卡波糖治疗,C组患者采用二甲双胍联合西格列汀治疗。比较三组患者治疗前后的1,5-脱水葡萄糖醇(1,5-AG)、糖化血红蛋白(HbA1c)、目标范围内血糖占比时间(TIR)及不良反应发生情况。结果干预后不同访视期,B、C组患者的1,5-AG水平均高于A组,差异有统计学意义(P<0.05);C组患者的1,5-AG均高于B组,差异有统计学意义(P<0.05)。干预后B、C组患者的HbA1c低于A组,差异有统计学意义(P<0.01);干预后B、C组患者的HbA1c比较,差异无统计学意义(P>0.05)。干预后B、C组患者的TIR高于A组,差异有统计学意义(P<0.01);干预后C组患者的TIR高于B组,差异有统计学意义(P<0.01)。A、C组患者的不良反应总发生率低于B组,差异有统计学意义(P<0.05);A、C组患者的不良反应总发生率比较,差异无统计学意义(P>0.05)。结论二甲双胍联合西格列汀治疗2型糖尿病能明显降低HbA1c,且患者的血糖波动更小,是一种更优化的降糖治疗方案。Objective To investigate the clinical effect of Metformin combined with Sitagliptin in the treatment of patients with type 2 diabetes.Methods A total of 105 patients with type 2 diabetes who were treated in Shanghai Oriental Hospital from January 2017 to July 2020 who treated with Metformin alone and had poor glucose control effects were selected as the research objects.Among them,5 cases fell out,and 100 cases were finally enrolled.They were divided into group A(30 cases),group B(35 cases)and group C(35 cases)by random number table.Patients in group A continued to be treated with Metformin,patients in group B were treated with Metformin combined with Acarbose.Patients in group C were treated with Metformin combined with Sitagliptin.1,5-dehydroglucositol(1,5-AG),glycated hemoglobin(HbA1c),blood glucose ratio time within the target range(TIR)and the incidence of adverse reactions in three groups were compared before and after treatment.Results After intervention,the level of 1,5-AG in groups B and C were higher than that in group A at different visit periods,and the differences were statistically significant(P<0.05).The 1,5-AG in group C was higher than that in group B,and the difference was statistically significant(P<0.05).After intervention,HbA1c in group B and C were lower than group A,and the differences were statistically significant(P<0.01).After intervention,there was no significant difference in HbA1c between group B and C(P>0.05).After intervention,TIR of group B and C were higher than that of group A,and the differences were statistically significant(P<0.01).After intervention,TIR in group C was higher than that in group B,and the difference was statistically significant(P<0.01).The total incidence of adverse reactions in group A and C were lower than that in group B,and the differences were statistically significant(P<0.05).There was no statistical significance in the total incidence of adverse reactions between group A and C(P>0.05).Conclusion The combination of Metformin and Sitagliptin can significa

关 键 词：1 5-脱水葡萄糖醇 糖化血红蛋白 血糖波动 目标范围内血糖占比时间 

分 类 号：R587.1[医药卫生—内分泌]