伏格列波糖联合艾塞那肽对2型糖尿病患者血糖控制效果及对血清成纤维细胞生长因子21水平的影响  

Effect of voglibose combined with exenatide on blood glucose control and serumfibroblast growth factor 21expression in patients with type 2 diabetes mellitus

作　　者：王大鹏[1] 王昕[1] 李杰[1] Wang Dapeng;Wang Xin;Li Jie(Department of Health Care and Geriatrics,Qingdao Municipal Hospital,Qingdao 266000,China)

机构地区：[1]青岛市市立医院保健老年内科,青岛266000

出　　处：《中国医师进修杂志》2022年第6期534-538,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨伏格列波糖联合艾塞那肽对2型糖尿病(T2DM)患者血糖控制效果及对血清成纤维细胞生长因子21(FGF-21)水平的影响。方法选取2018年10月至2020年9月青岛市市立医院收治的T2DM患者380例,按随机数字表法分为对照组与观察组,每组190例。对照组应用伏格列波糖治疗,观察组在对照组基础上联合艾塞那肽治疗,两组均治疗16周。比较两组治疗前后血糖、血脂、胰岛素等指标,以及血清FGF-21水平,并比较两组的疗效以及不良反应发生率。结果观察组治疗后总有效率高于对照组[97.89%(186/190)比93.16%(177/190)],差异有统计学意义(χ^(2)=5.00,P<0.05)。观察组治疗后空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)水平低于对照组[(6.95±1.03)mmol/L比(8.29±1.15)mmol/L、(7.88±2.07)mmol/L比(10.03±3.24)mmol/L、(7.17±1.08)%比(8.13±1.21)%](P<0.05)。观察组治疗后三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平低于对照组[(2.13±0.23)mmol/L比(2.93±0.34)mmol/L、(3.10±1.01)mmol/L比(3.98±1.14)mmol/L、(1.93±0.38)mmol/L比(2.73±0.54)mmol/L](P<0.05)。观察组治疗后胰岛β细胞功能指数高于对照组(111.56±20.78比102.23±20.14,P<0.05)。观察组治疗后血清FGF-21水平低于对照组[(142.09±26.82)ng/L比(150.22±30.21)ng/L](P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论伏格列波糖联合艾塞那肽对二甲双胍失效的T2DM患者疗效确切,可有效控制血糖水平,下调血清FGF-21水平,从而改善患者胰岛素抵抗和糖脂代谢,减轻体质量,安全性较高。Objective To investigate the effect of voglibose combined with exenatide on blood glucose control and serum fibroblast growth factor 21(FGF-21)expression in patients with type 2 diabetes mellitus(T2DM).Methods Three hundred and eighty patients with T2DM admitted to Qingdao Municipal Hospital from October 2018 to September 2020 were selected and randomly divided into the control group and the observation group,with 190 patients in each group.The control group was treated with voglibose,and the observation group was treated with voglibose and exenatide.Both groups were treated for 16 weeks.Blood glucose,blood fat,insulin and other indicators as well as serum FGF-21 levels were compared between the two groups before and after the treatment,and the efficacy of drugs and the incidence of adverse reactions were compared.Results The total effective rate in the observation group was higher than that in the control group:97.89%(186/190)vs.93.16%(177/190),χ^(2)=5.00,P<0.05.After treatment,the levels of fasting plasma glucose(FPG),2 h plasma glucose(2 h PG)and glycosylated hemoglobin(HbA1c)in the observation group were lower than those in the control group:(6.95±1.03)mmol/L vs.(8.29±1.15)mmol/L,(7.88±2.07)mmol/L vs.(10.03±3.24)mmol/L,(7.17±1.08)%vs.(8.13±1.21)%,P<0.05.After treatment,the levels of triacylglycerol(TG),total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)in the observation group were lower than those in the control group:(2.13±0.23)mmol/L vs.(2.93±0.34)mmol/L,(3.10±1.01)mmol/L vs.(3.98±1.14)mmol/L,(1.93±0.38)mmol/L vs.(2.73±0.54)mmol/L,P<0.05.After treatment,the level of isletβcell function index(HOMA-β)in the observation group was higher than that in the control group:111.56±20.78 vs.102.23±20.14,P<0.05.After treatment,the level of serum FGF-21 in the observation group was lower than that in the control group:(142.09±26.82)ng/L vs.(150.22±30.21)ng/L,P<0.05.The incidence of adverse reactions between the two groups had no significant difference(P>0.05).Conclusions Voglibose com

关 键 词：糖尿病 2型 成纤维生长因子21 胰岛素抗药性 伏格列波糖 艾塞那肽 

分 类 号：R587.1[医药卫生—内分泌]