西格列汀和吡格列酮在需大剂量胰岛素治疗T2DM患者中的应用效果对比研究

Comparative study on applicative effects of sitagliptin and pioglitazone in treatment of T2DM patients requiring high-dose insulin

目的对比西格列汀和吡格列酮在需大剂量胰岛素治疗2型糖尿病(T2DM)患者中的应用效果。方法按照随机数字表法将2017年3月～2018年3月于本院接受大剂量胰岛素治疗的200例2型糖尿病(T2DM)患者分为研究组(西格列汀,n=100)及对照组(吡格列酮,n=100)。比较治疗前、治疗2周时的相关血糖指标[空腹血糖(FBG)、餐后2h血糖(2hPG)、糖化血红蛋白(HbA1C)、空腹胰高血糖素(PGG)]、脂类指标[总胆固醇(CHOL)、甘油三酯(TG)]及炎性因子[同型半胱氨酸(Hcy)、超敏C反应蛋白(hsCRP)]水平表达情况差异,观察治疗过程中两组患者低血糖发生率。结果治疗2周时,相关血糖指标(FBG、2hPG、HbA1C、PGG)水平、脂类指标(CHOL、TG)水平、炎性因子指标(Hcy、hs-CRP)水平均较治疗前下降(P <0.05),且研究组低于对照组(P <0.05);研究组患者低血糖发生率为3.00%,低于对照组的14.00%,差异有统计学意义(χ2=7.740,P=0.005)。结论针对需大剂量胰岛素治疗T2DM患者的治疗,西格列汀相比吡格列酮对于血糖控制效果更佳。

Objective To compare the applicative effects of sitagliptin and pioglitazone in treatment of patients with type2diabetes mellitus(T2DM)requiring high-dose insulin.Methods200patients with type2diabetes mellitus(T2DM)who were treated with high-dose insulinin our hospital from March2017to March2018were selected and they were divided into study group(sitagliptin,n=100)and the control group(pioglitazone,n=100)according to random number table method.Expression levels of related blood glucose indexes[fasting bloodglucose(FBG),2h postprandial glucose(2hPG),glycated hemoglobin(HbA1C),fasting glucagon(PGG)],lipid indexes[total cholesterol(CHOL),triglyceride(TG)]and inflammatory factors[homocysteine(Hcy),hypersensitive C-reactive protein(hs-CRP)]before treatment and2weeks after treatment were compared.The occurrence rates of hypoglycemia during treatment of patients in two groups were observed.Results On2weeks after treatment,levels of related blood glucose indexes(FBG,2hPG,HbA1C,PGG),lipid indexes(CHOL,TG)and inflammatory factors(Hcy,hs-CRP)were lower than those before treatment(P<0.05).And those index levels in the study group was lower than the control group(P<0.05).The occurrence rate of hypoglycemiaof patients in the study group was3%,lower than that of the control group(14.00%.The difference was statistically significant(χ2=7.740,P=0.005).Conclusion For patients with type2diabetes mellitus(T2DM)requiring high-dose insulin,sitagliptin can better control blood glucose than pioglitazone.