二甲双胍联合西格列汀治疗2型糖尿病伴代谢综合征疗效评价

Clinical Evaluation on Metformin Combined with Glipetine in the Treatment of Type 2 Diabetes Mellitus and Metabolic Syndrome

目的探讨二甲双胍联合二肽基肽酶4(DPP-4)抑制剂对2型糖尿病(T2DM)伴代谢综合征(MS)患者机体糖脂代谢、微炎性反应的影响。方法选择医院2016年1月至2017年1月收治的T2DM伴MS患者186例,随机分为对照组(二甲双胍)和观察组(二甲双胍+西格列汀),各93例。结果治疗后,观察组空腹胰岛素(FPI)、空腹血糖(FBG)、胰岛素抵抗指数(HOMA-IR)水平均低于对照组(t=15.375,20.391,21.637,P<0.05),高密度脂蛋白胆固醇(HDL-C)高于对照组,总胆固醇(TC)、三酰甘油(TG)均低于对照组(t=19.287,8.545,8.728,P<0.05);观察组C反应蛋白、白细胞介素6、肿瘤坏死因子-α水平均低于对照组(t=44.889,14.280,17.291,P<0.05);生活质量评价量表(SF-36)4项内容评分均高于对照组(P<0.05);观察组低血糖发生率为1.08%,低于对照组的9.68%(χ2=6.763,P<0.05)。结论二甲双胍联合DPP-4抑制剂治疗T2DM伴MS,可使患者的糖脂代谢得到更大程度改善,减轻其机体炎性反应,有效提高生活质量。

Objective To investigate the effect of metformin combined with dipeptidyl peptidase-4(DPP-4)inhibitor on glycolipid metabolism and micro inflammatory response in patients with type 2 diabetes mellitus(T2DM)and metabolic syndrome(MS).Methods Totally 186 patients with T2DM and MS admitted to our hospital from January 2016 to January 2017 were selected and randomly divided into the control group(metformin)and the study group(metformin combined with glipetine),93 cases in each group..Results After treatment,the levels of FPI,FBG and HOMA-IR in the observation group were lower than those in the control group(t=15.375,20.391,21.637,P<0.05),the level of HDL-C in the observation group was higher than that in the control group,the levels of TC and TG in the observation group were lower than those in the control group(t=19.287,8.545,8.728,P<0.05).After treatment,the levels of CRP,IL-6,TNF-αin the observation group were lower than those in the control group(t=44.889,14.280,17.291,P<0.05),the scores of 4 items of SF-36 in the observation group were higher than those of the control group(P<0.05).The incidence rate of hypoglycemia in the observation group was 1.08%,which was lower than 9.68%in the control group(χ2=6.763,P<0.05).Conclusion Metformin combined with DPP-4 inhibitor for treating T2DM and MS can significantly improve the glycolipid metabolism of the patients,reduce the inflammatory response and effectively improve the quality of life.