沙格列汀联合胰岛素治疗2型糖尿病的临床研究

Clinical study on treatment of type 2 diabetes by saxagliptin combined with insulin

目的探讨沙格列汀联合胰岛素治疗2型糖尿病的疗效及安全性。方法选取2011年8月至2013年8月我院收治的2型糖尿病患者共320例,按照随机数字表法分为观察组和对照组各160例。观察组给予沙格列汀联合胰岛素治疗;对照组给予胰岛素治疗,疗程为12周。观察两组治疗前后的空腹血糖、餐后2 h血糖、糖化血红蛋白、空腹血清C肽水平、餐后2 h血清C肽水平和血脂、肝功能及肾功能等。结果治疗前,两组的各项观察指标比较差异均无统计学意义(P>0.05);与治疗前和对照组治疗后比较,治疗后观察组的空腹血糖、餐后2 h血糖与糖化血红蛋白明显降低;空腹血清C肽水平、餐后2 h血清C肽水平明显升高;甘油三酯、低密度脂蛋白水平明显降低,高密度脂蛋白明显升高;观察组人均每日胰岛素用量明显低于对照组(P<0.05);观察组治疗后体重指数明显低于对照组,低血糖发生率明显低于对照组(P<0.05),未发生肝肾功能损害。结论沙格列汀联合胰岛素治疗2型糖尿病可以有效控制血糖,减少胰岛素的用量,且不良反应小,是一种安全可靠的治疗方法。

Objective To study the effect and safety of type 2 diabetes treated by saxagliptin combined with insulin. Methods 320 patients with type 2 diabetes were enrolled in this study, seen in our hospital from August 2011 to August 2013, and were divided into observation group and control group with 160 cases in each one, accord-ing to random number table method. During 12 weeks, observation group was given saxagliptin combined with insu-lin, while the control group was treated with insulin only. And then the fasting blood glucose, 2 h post-meal blood glu-cose, glycosylated hemoglobin, fasting serum c-peptide levels, 2h post-meal serum c-peptide levels, blood lipid, liver and kidney function were examined in two groups before and after treatment. Results There was no difference in the observation indexes between the two groups before the treatment （P〉0.05）. After treatment, the fasting glucose, 2 h post-meal blood glucose, glycosylated hemoglobin, triglyceride, and low density lipoprotein levels in observation group were significantly lower than those in control group. And the fasting serum c-peptide levels, 2 h post-meal se-rum c-peptide levels and high density lipoprotein in observation group were higher than those in control group. Mean daily insulin dosage, body mass index, and the incidence of low blood glucose in observation group were significantly lower than those in the control group （P〈0.05）. No liver or kidney function damage was found. Conclusion Type 2 diabetes treated by saxagliptin combined with insulin can effectively control blood glucose and reduce the dosage of insulin with less adverse reaction, which was recommended as a safe and reliable choice.