维格列汀联用二甲双胍对2型糖尿病患者血糖控制效果及SPARC表达的影响

Effect of Vildagliptin with Metformin on Glycemic Control and the Expression of SPARC in Type 2 Diabetes

目的探讨维格列汀联用二甲双胍对2型糖尿病患者血糖控制效果及富含半胱氨酸的酸性分泌蛋白(SPARC)表达的影响。方法选取2013年12月至2015年12月在天津市滨海新区大港中医医院就诊的2型糖尿病患者120例,采用随机数字法分为对照组和观察组,各60例。对照组口服二甲双胍(0.5 g/d)进行治疗;观察组口服二甲双胍(0.5 g/d)联合维格列汀(50 mg/d)进行治疗。对两组患者治疗前后血糖控制效果及SPARC表达变化进行分析比较。结果治疗后,观察组空腹血糖、餐后2 h血糖以及糖化血红蛋白均低于对照组[(7.24±2.59)mmol/L比(8.56±1.97)mmol/L,(5.04±0.33)%比(6.88±0.07)%,(13.62±0.87)mmol/L比(15.41±0.98)mmol/L](P<0.01)。治疗后,观察组尿糖低于对照组[(13.62±0.87)mmol/L比(15.41±0.98)mmol/L](P<0.01)。治疗后,观察组餐后C肽及SPARC水平均低于对照组[(4.61±1.42)μg/L比(5.51±1.81)μg/L,(3.89±0.77)μg/L比(4.85±0.48)μg/L](P<0.01)。观察组低血糖发生率低于对照组[3.3%(2/60)比15.0%(9/60)](P<0.05)。结论采用维格列汀联合二甲双胍治疗2型糖尿病患者,血糖控制效果良好,SPARC表达降低,且低血糖发生率低。

Objective To observe the effect of vildagliptin with metformin on glycemic control and the expression of secreted protein acidic and rich in cysteine （SPARC） in type 2 diabetes. Methods A total of 120 patients with type 2 diabetes in Tianjin Binhai New Area Dagang Chinese Medicine Hospital during Dec. 2013 and Dec. 2015 were divided into two groups：50 mg/d vildagliptin with 0. 5 g/d metformin were used in the observation group, while the control group was treated with 0. 5 g/d metformin. The glycemic and SPARC expression of the two groups were analyzed and compared. Results The fasting plasma glucose, postprandial 2 h plasma glucose, glycosylated hemoglobin, urine glucose after treatment in the observation group were lower than those of the control group[ （7. 24 ±2. 59） mmol/L vs （8.56 ± 1.97） mmol/L, （5.04 ±0. 33）% vs （6. 88 ±0. 07） % ,（13.62 ±0. 87） mmol/L vs （ 15.41 ±0.98） mmol/L, （ 13.62 ±0. 87） mmol/L vs （ 15.41 ± 0. 98 ） mmol/L ] （ P 〈 0. 01 ）. The postprandial C peptide, SPARC expression after treatment in the observation group were lower than those of the control group[ （4. 61 ± 1.42） μg/L vs （5.51 ± 1.81 ） μg/L, （ 3.89 ± 0. 77 ） μg/L vs （4. 85 ±0. 48 ） μg/L] （P 〈 0. 01 ）. The incidence of hypoglycemia in the observation group was lower than that of the control group [ 3.3 % （ 2/60 ） vs 15.0% （ 9/60 ） ] （ P 〈 0. 05 ）. Conclusion Metformin plus vildagliptin treatment of type 2 diabetes,is featured with good glycemie control,lower expression of SPARC and lower incidence of hypoglycemia.