西格列汀联合二甲双胍对2型糖尿病患者血糖水平及心血管事件发生率的影响

Effect of sitagliptin plus melbine on blood glucose and incidence rate of cardiovascular events in patients with type 2 diabetes mellitus

目的探讨西格列汀联合二甲双胍治疗2型糖尿病(T2DM)的临床疗效及安全性。方法将208例T2DM患者随机分为二甲双胍+西格列汀组(MET/SITA组)105例和二甲双胍+阿卡波糖组(MET/DM组)103例,分别于服药前、服药后第12、24、48周检测患者体质量指数(BMI)、空腹血糖(FBG)、餐后2 h血糖(2h PPG)、糖化血红蛋白(Hb A1c)、三酰甘油(TG)、胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)和胰岛素抵抗指数(HOMA-IR)。随访记录不良反应和心血管事件发生率。结果 MET/SITA组BMI显著低于治疗前和MET/DM组(P<0.01)。治疗24和48周后,MET/SITA组FBG、2h PPG和Hb A1c显著低于治疗前和MET/DM组,差异有统计学差异(P<0.01)。随访发现,MET/SITA组心血管事件发生率显著低于MET/DM组,且生存周期较长。结论西格列汀联合二甲双胍治疗T2DM疗效佳,且安全性高。

Objective To explore the clinical efficacy and safety of sitagliptin plus melbine in the treatment of type 2 diabetes mellitus（ T2DM）. Methods A total of 208 patients with T2 DM were randomly divided into sitagliptin plus melbine group（ MET / SITA group,n = 105） and melbine plus acarbose group（ MET / DM group,n = 103）. Before administration and 12,24 and 48 weeks after administration,the following indexes were detected in two groups,including body mass index（ BMI）,fasting blood glucose（ FBG）, 2 h postprandial glucose（ 2h PPG）, glycosylated hemoglobin（ Hb A1c）,triacylglycerol（ TG）,cholesterol（ TC）,low-density lipoprotein cholesterol（ LDL-C）,high-density lipoprotein cholesterol（ HDL-C） and homeostasis model assessment-insulin resistance index（ HOMA-IR）. The incidence rate of adverse reactions and cardiovascular events were recorded in follow-up period. Results BMI in MET / SITA group was significantly lower than that before administration and in MET / DM group（ P〈0. 01）. 24 and 48 weeks after administration,the levels of FBG,2 h PPG and Hb A1 c in MET / SITA group were significantly lower than those before administration and in MET / DM group（ P〈0. 01）. In follow-up period,the incidence rate of cardiovascular events in MET / SITA group was still lower than that in MET / DM group,and the survival time of patients in MET / SITA group was longer. Conclusion For patients with T2 DM,sitagliptin plus melbine has better clinical efficacy and higher safety.