胰岛素控制不佳的2型糖尿病并冠心病患者加用磷酸西格列汀临床观察

Effect of sitagliptin phosphate on poor insulin control of type 2 diabetes and coronary heart disease

目的 观察磷酸西格列汀对胰岛素控制不佳的2型糖尿病并冠心病患者的疗效与安全性.方法 选38例使用胰岛素血糖控制不佳的2型糖尿病并冠心病患者,加用磷酸西格列汀100 mg,每天1次,口服.根据血糖监测情况调整胰岛素用量,了解血糖、糖化血红蛋白、血压、体质量及低血糖发生情况.并观察心电图、血常规、肝肾功能、血脂变化.结果 治疗期间1例因皮肤瘙痒用抗过敏药效果不佳停用磷酸西格列汀,观察实际为37例,治疗后3个月血糖水平及糖化血红蛋白及胰岛素用量均下降,与治疗前比较差异有统计学意义（P＜0.05）;体质量、血压改变与治疗前比较差异无统计学意义（P＞0.05）.同时观察到心电图、血脂、肝肾功能、血常规无明显变化.结论 胰岛素控制不佳的2型糖尿病并冠心病患者加用磷酸西格列汀治疗有效、安全,可以减少胰岛素用量.

Objective To observe the effect of sitagliptin phosphate on poor insulin control of type 2 diabetes and coronary heart disease.Methods Thirty-eight cases of poor insulin control of type 2 diabetes and coronary heart disease patients were given sitagliptin phosphate,100 mg,once a day,orally.The insulin dosage was adjusted according to the monitoring of blood glucose,and the blood glucose,glycosylated hemoglobin,blood pressure,body weight and incidence of hypoglycemia was observed.And the changes of ECG,blood routine,liver and kidney function and blood lipid was observed.Results One case stop ped taking sitagliptin phosphate because of skin pruritus during treatment with anti allergy medicine.So there were thirty-seven patients in this study,the blood glucose and glycosylated hemoglobin and insulin dosage decreased 3 months after treatment than before treatment （P 〈 0.05） ; The body weight and blood pressure after treatment had no significant difference compared with those before treatment （P 〉0.05）.At the same time,ECG,blood lipid,liver and renal function,blood routine test also showed no obvious change.Conclusions Sitagliptin phosphate in treatment of poor controll type 2 diabetes and coronary heart disease is effective and safe,and the dosage of insulin can be reduced.