西格列汀联合二甲双胍对2型糖尿病患者糖、脂代谢及胰岛素抵抗的影响

EFFECTS OF SITAGLIPTIN COMBINED WITH METFORMIN ON BLOOD LIPID,BLOOD GLUCOSE AND INSULIN RESISTANCE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

目的探究西格列汀联合二甲双胍对2型糖尿病患者的血脂、血糖、胰岛β细胞分泌功能、胰岛素抵抗的影响。方法 2014年1月—2016年12月就诊于本院的确诊为2型糖尿病患者200例,100例采用二甲双胍治疗(对照组),100例在对照组的基础上联合西格列汀治疗(观察组),记录并比较二组患者的血脂水平、血糖水平、胰岛β细胞分泌功能、胰岛素抵抗指标,同时比较二组患者的临床疗效和不良反应发生情况。结果二组患者治疗后血糖指标、血脂指标均有显著改善,胰岛β细胞分泌功能均有显著提升,胰岛素抵抗指数均有显著下降(P<0.05);治疗后观察组的空腹血糖、午餐后2h血糖、糖化血红蛋白C指标低于对照组(P<0.05),胆固醇、甘油三酯、低密度脂蛋白低于对照组(P<0.05),高密度脂蛋白高于对照组(P<0.05),胰岛β细胞分泌功能高于对照组(P<0.05),胰岛素抵抗指数低于对照组(P<0.05);在疗效方面,观察组的总有效率高于对照组(P<0.05)。结论西格列汀联合二甲双胍能够有效控制2型糖尿病患者的血脂血糖水平,提高胰岛β细胞分泌功能,降低胰岛素抵抗,适合推广应用。

Objective To investigate the effects of Sitagliptin on blood lipid,blood glucose,isletβcell secretion function and insulin resistance in patients with type 2 diabetes mellitus.Methods From January 2014 to December 2016,200 patients with type 2 diabetes were randomly divided into control group and observation group,100 cases in each group.The Patients in the control group were treated with Metformin and the patients in the observation group were treated with Metformin and Sitagliptin.The levels of blood lipid,blood glucose,homeostasis model assessmentβand insulin resistance were recorded and compared between the two groups.The clinical efficacy and adverse reactions were also compared between the two groups.Results After treatment,the levels of blood glucose and blood lipid were significantly decreased in both groups,and the homeostasis model assessmentβwas significantly increased and the insulin resistance index was significantly decreased（P〈0.05）.After the treatment,the levels of FBG,2 hPBG,HbAlc,TC,TG,LDL-C and HOMA-IR of the observation group were significantly lower than those of the control group（P〈0.05）,and FINS,PINS and HOMA-βwere significantly higher than that of the control group（P〈0.05）.The total efficacy of the observation group was significantly higher than that of the control group（P〈0.05）.There was no significant difference in the incidence rate（P〈0.05）.Conclusion Sigmatidine can effectively control the level of blood lipid and blood glucose in patients with type 2 diabetes mellitus,improve the isletβcell secretion function and reduce the insulin resistance.It is suitable for popularization and application.