DPP-4抑制剂与二甲双胍联合治疗在T2DM合并代谢综合症患者中的临床研究

The clinical analysis of DPP-4 inhibitor combined with metformin in the T2DM patients combined with MS

目的:讨论二肽基肽酶-4(DPP-4)抑制剂联合二甲双胍治疗在2型糖尿病(type 2 diabetes mellitus,T2DM)合并代谢综合症(metabolic syndrome,MS)患者中的临床应用价值。方法:分析200例T2DM合并MS患者的临床资料,将入选者随机分成观察组(二甲双胍+DPP-4抑制剂)和对照组(二甲双胍)两组,每组各100例。比较两组治疗前后的糖脂代谢情况及微炎症状态。结果:治疗后两组患者的糖脂代谢情况均明显好于治疗前(P <0. 05);治疗后观察组患者的FPI、FPG、HOMAIR、TC、TG水平均明显低于对照组,HDL-C水平明显高于对照组(P <0. 05);治疗后,两组患者各炎症因子水平均明显低于治疗前(P> 0. 05);治疗后观察组患者的CRP、IL-6及TNF-α水平均明显低于对照组(P <0. 05)。结论:DPP-4抑制剂联合二甲双胍不仅可以有效改善T2DM合并MS患者微炎症状态,而且可以纠正糖脂代谢紊乱现象,值得推广。

Objective： To analyze the clinical application value of DPP-4 inhibitor combined with metformin in the T2DM patients combined with MS. Methods： Clinical data of 200 T2DM patients with MS was retrospectively analyzed.Patients included were divided into two groups randomly,observation group （DPP-4 inhibitor combined with metformin） and control group （metformin）,100 cases in each group.The general information,the situation of glucose and lipid metabolism and the microinflammatory state before and after treatment in two groups were compared. Results： The situation of glucose and lipid metabolism in two groups after treatment were better than those before treatment （ P 〈0.05）.The levels of FPI,FPG,HOMA-IR,TC,TG in observation group after treatment were obviously lower than those in control group,the HDL-C level in observation group after treatment was obviously higher than those in control group （ P 〈 0.05）.The levels of inflammatory factors after treatment were obviously lower than those before treatment in two groups （ P 〈 0.05）.The levels of CRP,IL-6 and TNF-α in observation group were obviously lower than those in control group after treatment （ P 〈0.05）. Conclusion： The DPP-4 inhibitor combined with metformin can not only improve the microinflammatory state,but also correct the disorder of glucose and lipid metabolism,which is worth promoting.