瑞格列奈与阿卡波糖治疗糖耐量异常的疗效观察

EFFICACY COMPARISON OF REPAGLINIDE AND ACARBOSE IN TREATMENT OF IMPAIRED GLUCOSE TOLERANCE

目的比较瑞格列奈与阿卡波糖对糖耐量异常者的疗效。方法采用开放性研究,2组间对照及治疗前后自身比较。瑞格列奈组服用瑞格列奈0.5mg,3次/d,阿卡波糖组服阿卡波糖50mg,3次/d,疗程均为18个月。检测治疗前后空腹血糖(fasting blood glucose,FBG)、餐后血糖(postprandial blood glucose,PBG)、糖化血红蛋白(hemoglobin A_(1c),HbA_(1c)),体质量指数(body mass index,BMI)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、肝肾功能的变化。结果与治疗前比较,瑞格列奈组FBG下降1.25mmol/L,PBG下降1.75mmol/L,HbA_(1c)下降1.05%(P<0.05);TC、TG分别下降0.24和0.13mmol/L(P>0.05);BMI、肝肾功能无变化,中餐前发生轻微低血糖6例。阿卡波糖组FBG下降0.99mmol/L,PBG下降2.17mmol/L,HbA_(1c)下降1.30%,BMI下降2.46(P<0.05);TG、TC下降0.13和0.32mmol/L(P>0.05),肝肾功能无变化,无低血糖发生。阿卡波糖组PBG、BMI下降较瑞格列奈组明显,差异有统计学意义(P<0.05)。结论瑞格列奈与阿卡波糖均对糖耐量异常有效,但阿卡波糖具安全性、耐受性良好的特点。阿卡波糖降低PBG、HbA_(1c)、BMI等方面均优于瑞格列奈;瑞格列奈降低FBG优于阿卡波糖。阿卡波糖在治疗糖耐量异常优于瑞格列奈。

Objective To compare the effects of repaglinide and acarbose in the treatment of patients with impaired glucose tolerance. Methods Fourty patients with impaired glucose tolerance were divided into 2 groups, repaglinide group and aearbose group, and received an 18 -month course of treatment. Fast blood glucose （ FBG）, postprandial blood glucose （ PBG）, hemoglobin Ale （ HbAlc ）, body mass index （BMI）, total cholesterol （TC）and triglyceride （TG） were compared between the two groups before and after therapy. Results After treatment, the Repaglinide group, FBG, PBG, and HbA1C decreased by 0.25mmol/L, 1. 75mmol/Land 1.05% , respectively （P 〈 0. 05） ; TC and TG decreased by 0. 24 and 0. 13mmol/L respectively （P 〉 0.05） ; BMI and hepatic and renal function were not changed ; Six patients had light glycopenia before lunch and were avoided by eating early. The second group, FBG, PBG, and HbA1C decreased by 0.99mmol/L,2.17mmol/L, 1.30%, and 2.46, respectively （ P 〈 0.05 ） TC and TG decreased by 0.13 and 0.32mmol/L respectively （P 〉 0.05 ） ; The renal function were not changed and no glycopenia happened. Conclusion Repaglinide and aearbose are both effective in the treatment of patients with impaired glucose tolerance but acarbose has advantages including safety and good tolerance.