阿格列汀与阿卡波糖治疗新诊2型糖尿病的效果及对胃肠道相关激素的影响比较

Comparison effect of Alogliptin and Acarbose in the treatment of newly diagnosed type 2 diabetes mellitus and their effects on gastrointestinal related hormones

目的探讨阿格列汀与阿卡波糖对新诊2型糖尿病(7%<糖化血红蛋白(HbA1c)<8.5%)患者的临床效果及对胃肠道相关激素的影响。方法选取2017年1月～2018年1月我院内分泌科收治的60例新诊2型糖尿病患者作为研究对象,按照随机数字表法分为治疗组与对照组,每组30例。治疗组患者给予阿格列汀治疗,对照组患者给予阿卡波糖治疗,两组分别治疗24周。比较两组患者治疗前后血糖、HbA1c、体重指数(BMI)、胃肠道激素的变化及不良反应发生情况。结果两组患者治疗后的空腹血糖(FPG)、餐后2 h血糖(2 h PG)及HbA1c水平均低于治疗前,差异有统计学意义(P<0.05);两组患者治疗后的BMI水平低于治疗前,但差异无统计学意义(P>0.05);两组患者的FPG、2 h PG、HbA1c比较,差异无统计学意义(P>0.05)。治疗组患者治疗后的空腹及餐后2 h的胃饥饿素及胃泌素均低于治疗前,差异有统计学意义(P<0.05);对照组患者治疗后的空腹及餐后2 h的胃饥饿素低于治疗前,空腹及餐后2 h的胃泌素高于治疗前,但差异无统计学意义(P>0.05)。治疗组患者治疗后的空腹及餐后2 h的胃饥饿素及胃泌素低于对照组,差异均有统计学意义(P<0.05)。两组患者均未发生的严重的胃肠道不良反应及严重低血糖。结论阿格列汀与阿卡波糖均能显著改善新诊2型糖尿病患者(7%<HbA1c<8.5%)的血糖水平,但阿格列汀降低空腹及餐后胃饥饿素的作用更显著,可以作为临床治疗2型糖尿病的有效方案。

Objective To investigate the clinical effects of Alogliptin and Acarbose on newly diagnosed type 2 diabetes mellitus(7%<HbA1c<8.5%)and their effects on gastrointestinal hormones.Methods Sixty newly diagnosed type 2 diabetes mellitus patients in the Department of endocrinology of our hospital from January 2017 to January 2018 were selected,they were divided into treatment group and control group according to random number table method,with 30 cases in each group.The patients in the treatment group were treated with Alogliptin and the patients in the control group were treated with Acarbose for 24 weeks.Blood sugar,HbA1c and body mass index(BMI)were compared between the two groups before and after treatment,changes of gastrointestinal hormones and occurrence of adverse reactions.Results The levels of fasting blood glucose(FPG),postprandial 2-hour blood glucose(2-hour PG)and HbA1c in the two groups after treatment were lower than those before treatment,and the differences were statistically significant(P<0.05).BMI level of the two groups after treatment was lower than that before treatment,but there was no significant difference(P >0.05).There was no significant difference in FPG,2 h PG and HbA1c between the two groups(P >0.05).Gastrin and gastrin levels in the treatment group after treatment were lower than those before treatment on fasting and 2 hours after meal(P<0.05).In the control group after treatment,the level of ghrelin in fasting and 2 hours after meal was lower than that before treatment,and the level of ghrelin in fasting and 2 hours after meal was higher than that before treatment,but there was no significant difference(P >0.05).The levels of ghrelin and gastrin in the treatment group after treatment were lower than those in the control group on fasting and 2 hours after meal(P<0.05).There were no severe gastrointestinal adverse reactions and severe hypoglycemia in both groups.Conclusion Both Alogliptin and Acarbose significantly improved blood sugar in newly diagnosed type 2 diabetes mellitus(7%<HbA1c<8.5%),however,the effect of agritin on reducing fasting and postprandial gastrin is more significant,and it can be used as an effective clinical treatment for type 2 diabetes mellitus.