【摘要】 目的探讨DPP-4抑制剂沙格列汀与磺酰脲类药物格列美脲治疗2型糖尿病的临床治疗效果及价值。方法 60例给予小剂量格列美脲控制血糖不佳的2型糖尿病患者,随机分为观察组和对照组,各30例。观察组给予沙格列汀联合格列美脲治疗,对照组给予增加格列美脲剂量治疗。比较分析两组治疗前及治疗3个月后患者空腹血糖(FPG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(HbA1c)以及低血糖发生情况。结果观察组治疗后的FPG、2 h PG、HbA1c分别为(6.93±0.87)mmol/L、(8.90±2.03)mmol/L和(6.90±0.43)%均显著低于治疗前的(9.75±1.33)mmol/L、(14.53±2.90)mmol/L和(8.65±0.83)%,差异有统计学意义(P<0.05);对照组治疗后的FPG、2 h PG、HbA1c分别为(6.97±0.94)mmol/L、(10.11±1.70)mmol/L和(7.01±0.37)%均显著低于治疗前的(9.80±1.57)mmol/L、(13.95±2.12)mmol/L和(8.67±0.79)%,差异有统计学意义(P<0.05)。观察组治疗后FPG、HbA1c与对照组治疗后FPG、HbA1c比较,差异无统计学意义(P>0.05);观察组治疗后2 h PG(8.90±2.03)mmol/L明显低于对照组治疗后2 h PG(10.11±1.70)mmol/L,差异有统计学意义(P<0.05)。对照组低血糖发生率为20%,观察组低血糖发生率为0,比较差异有统计学意义(P<0.05)。结论在2型糖尿病患者的治疗当中,当小剂量格列美脲控制血糖不达标时,可以给予联合沙格列汀或增加格列美脲剂量,两者均能有效控制血糖,但前者能够更好地控制餐后血糖,减少低血糖风险,具有较好的临床疗效,值得临床推广。更多还原

【Abstract】 Objective To investigate the clinical therapeutic effect and value of DPP-4 inhibitor Saxagliptin combined with sulfonylurea Glimepiride in the treatment of type 2 diabetes mellitus.Methods A total of type 2 diabetic mellitus patients with poorly controlled glycemic control who received low dose Glimepiride were randomly divided into observation group and control group, 30 cases in each group.The observation group was given Saxagliptin combined with Glimepiride for treatment, the control group was given additional dose of Glimepiride for treatment.The fasting plasma glucose(FPG), postprandial 2 h plasma glucose(2 h PG) and glycated hemoglobin(HbA1c) before and after 3 months of treatment, and occurrence of hypoglycemia after treatment between the two groups were compared and analyzed.Results The FPG, 2 h PG and HbA1c of the observation group after treatment were(6.93±0.87) mmol/L,(8.90±2.03) mmol/L and(6.90±0.43)% respectively, which were significantly lower than(9.75±1.33) mmol/L,(14.53±2.90) mmol/L and(8.65±0.83)% before treatment, the differences were statistically significant(P<0.05).The FPG, 2 h PG and HbA1c of the control group after treatment were(6.97±0.94) mmol/L,(10.11±1.70) mmol/L and(7.01±0.37)% respectively, which were significantly lower than(9.80±1.57) mmol/L,(13.95±2.12) mmol/L and(8.67±0.79)% before treatment, the differences were statistically significant(P<0.05).There were no significant differences in the FPG and HbA1c between the observation group and the control group after treatment(P>0.05).The 2 h PG of the observation group after treatment was(8.90±2.03) mmol/L, which was significantly lower than(10.11±1.70) mmol/L of the control group, the difference was statistically significant(P<0.05).The incidence of hypoglycemia in the control group was 20%, and no hypoglycemia occurred in the observation group, the difference was statistically significan(P<0.05).Conclusion In the treatment of type 2 diabetes mellitus patients, when the low dose of Glimepiride is not up to the standard, it can be given combined with Saxagliptin or increased dose of Glimepiride.Both of them can effectively control plasma glucose, but the former can better control postprandial plasma glucose, reduce the risk of hypoglycemia, and has better clinical efficacy, which is worthy of clinical promotion.更多还原