阿格列汀联合二甲双胍对2型糖尿病合并血脂异常患者血糖、血脂及对合并微量白蛋白尿患者UACR的影响观察

Observation on the Effects of Alogliptin Combined with Metformin on Blood Glucose,Blood Lipid in Patients with Type 2 Diabetes Mellitus and Dyslipidemia and UACR in Patients Complicated with Microalbuminuria

目的:探讨阿格列汀和二甲双胍联合应用对2型糖尿病合并血脂异常患者血糖、血脂指标,以及微量白蛋白尿(MAU)患者糖尿病肾病早期损害指标的影响。方法:90例2糖尿病伴血脂异常患者随机分为3组各30例。M组(含3例MAU患者)予盐酸二甲双胍片500 mg,po,tid;A组(含2例MAU患者)予苯甲酸阿格列汀片25mg,po,qd;M+A组(含3例MAU患者)予盐酸二甲双胍片500 mg,po,tid,联合苯甲酸阿格列汀片25 mg,po,qd。治疗16周后,比较3组患者治疗前后的空腹血糖(FBG)、餐后2 h血糖(2h PBG)、糖化血红蛋白(HbA1c)、总胆固醇(TG)、三酰甘油(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)等指标的变化;以及MAU患者尿微量白蛋白(UMalb)与尿肌酐(Ucr)的比值(UACR)。结果:治疗后,3组患者的血糖和血脂指标均较治疗前显著改善(P<0.05)。M+A组治疗后血糖及血脂指标均显著优于M组和A组(P<0.05)。治疗后,3组中MAU患者的UACR均较治疗前有所下降,且M+A组和A组患者的UACR下降更明显。结论:阿格列汀联合二甲双胍明显增强了降糖和降脂作用效果,且能降低2型糖尿病MAU患者的UACR,初步提示了阿格列汀对糖尿病患者肾脏的保护作用。

Objective ：To investigate the effect of alogliptin combined with metformin on blood glucose and blood lipid levels in patients with type 2 diabetes mellitus, and preliminary observe the effect of index in microalbuminuria （MAU） patients on early diabetic nephropathy. Methods ：90 type 2 diabetes mellitus patients with dyslipidemia were ran- domly divided into three groups （ n = 30）. The patients of metformin group （ group M, include 3 MAU patients） were given metformin 500 mg, po, tid. The patients of alogliptin group （ group A, include 2 MAU patients） were given alogliptin 25 mg, po, qd. And the patients of metformin combined with alogliptin group （ group M ＋ A, include 3 MAU patients） were given metformin 500 mg, po, tid combined alogliptin 25 mg, po, qd. The three groups were treated for 16 weeks. The fast- ing blood glucose （FBG）, postprandial 2 hours blood glucose （PBG）, glycosylated hemoglobin （HbAlc）, cholesterol （TG）, triglyceride （TC）, high-density lipoprotein cholesterol （HDL-C） , low-density lipoprotein cholesterol （ LDL-C ） before and after treatment of three groups, and UACR of the MAU patients in the three groups were compared. Results： The blood glucose, HbAlc and blood lipid indexes of the three groups after treatment were significantly better compared to those before treatment （P 〈 0.05 ）. After treatment, compared with the single drug group, the changes of blood glucose and blood lipid index in the M ＋ A group were more obvious （P 〈 0.05 ）. After treatment, the UACR of MAU patients in the tree groups were all decreased than before, and in group A and group M ＋ A, the UACR of patients with MAU was decreased more significantly. Conclusion： The effect of alogliptin combined with metformi was obvious in glucose-lowering and lipid-lowering. Alogliptin combined with metformi could reduce the UACR of patients with type 2 diabetes, and preliminarily hint at the protective effects of alogliptin on the kidney of diabetic patients.