达格列净联合阿卡波糖治疗初诊2型糖尿病的疗效及对血清视黄醇结合蛋白4水平的影响  

Effect of dagglitazine combined with acarbose in the treatment of newly diagnosed type 2 diabetes mellitus and the level of serum retinol binding protein 4

作　　者：王亮[1] 刘安宁[1] 陈利灵 李红玲 郑宽勇 WANG Liang;LIU Anning;CHEN Liling;LI Hongling;ZHENG Kuanyong(Department of Endocrinology,Xiantao First People's Hospital Affiliated to Yangtze University,Hubei Province,Xiantao 433000,China)

机构地区：[1]长江大学附属仙桃市第一人民医院内分泌科,湖北省仙桃市433000

出　　处：《临床合理用药杂志》2022年第11期20-22,27,共4页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的观察达格列净联合阿卡波糖治疗初诊2型糖尿病(T2DM)患者的临床效果及对血清视黄醇结合蛋白4(RBP4)水平的影响。方法选取2018年4月—2019年3月长江大学附属仙桃市第一人民医院内分泌科住院的初诊2型糖尿病患者84例,根据随机数字表法分为观察组和对照组,每组42例。观察组患者给予达格列净联合阿卡波糖治疗,对照组患者给予门冬胰岛素30联合阿卡波糖治疗,2组均连续治疗12周。比较2组患者治疗前后空腹血糖(FPG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA_(1c))、体质指数(BMI)、空腹胰岛素(FINS)、胰岛β细胞分泌指数(HOMA-β)、血清RBP4变水平,患者血糖达标时间、治疗费用及不良反应。结果治疗12周后,2组FPG、2 hPG、HbA_(1c)较治疗前下降明显(P<0.01),而FINS、HOMA-β较治疗前显著升高(P<0.01),但2组间比较差异无统计学意义(P>0.05)。对照组治疗12周后BMI与治疗前比较上升(P<0.05),而RBP4水平与治疗前比较差异无统计学意义(P>0.05);观察组治疗12周后BMI、RBP4较治疗前下降,且观察组治疗后BMI、RBP4低于对照组(P<0.05或P<0.01)。2组血糖达标时间与治疗总费用比较差异无统计学意义(P>0.05)。治疗过程中,观察组不良反应总发生率为7.14%,低于对照组的23.81%(χ^(2)=4.459,P=0.035)。结论达格列净联合阿卡波糖治疗初诊2型糖尿病患者的疗效确切,能有效降低体质量,可改善胰岛β细胞功能,缓解胰岛素抵抗,且不良反应发生率低,值得推广应用。Objective To investigate the effect of dapagliflozin combined with acarbose in the treatment of newly diagnosed type 2 diabetes mellitus and its effect on the level of serum retinol binding protein 4(RBP4).Methods To choose 84 cases of the newly diagnosed type 2 diabetes mellitus patients in hospital,which were from Department of Endocrinology,Xiantao First People's Hospital Affiliated to Yangtze University between April 2018 and March 2019,and 42 cases in each group,were randomly divided into observation group(dagglitazine combined with acarbose)and control group(Insulin Aspart 30 combined with acarbose),comparing the changes of two groups of patients before and after the treatment,which were included glycosylated hemoglobin(HbA_(1c)),body mass index(BMI),fasting plasma glucose(FPG),2 hours postprandial blood glucose(2 hPG),fasting insulin(FINS),islet beta cell secretion index(HOMA-β)and serum RBP4,and observing blood glucose standard time,treatment costs and adverse reactions of two groups of patients.Results After 12 weeks of continuous treatment,HbA_(1c)、FPG、2 hPG in the two groups significantly decreased compared with before treatment(P<0.01),HOMA-β,FINS significantly increased compared with before treatment(P<0.01).There was no statistically significant difference between the two groups(P>0.05).BMI in the control group significantly increased compared with before treatment(P<0.05).RBP4 in the control showed no significant change compared with that before treatment(P>0.05).BMI、RBP4 in the observation group decreased significantly compared with that before treatment,and BMI、RBP4 in the observation group decreased significantly compared with that in the control group(P<0.05 or P<0.01).There was no statistically significant difference between the two groups in the time of blood glucose up to the standard and the total cost of treatment of 12 weeks(P>0.05).During the treatment,the total incidence of adverse reactions in the observation group was 7.14%,which was lower than 23.81%in the control group(χ^

关 键 词：2型糖尿病 初次诊断 达格列净 阿卡波糖 临床效果 血清视黄醇结合蛋白4 

分 类 号：R587.1[医药卫生—内分泌]