长短效磺脲类药物联合治疗2型糖尿患者的疗效和不良反应观察

Efficacy and adverse reactions of long-acting and short-acting sulfonylureas in treatment of type 2 diabetes mellitus

目的探讨长短效磺脲类药物联合治疗2型糖尿病患者的疗效和不良反应。方法接受诊治的2型糖尿病患者62例,按照随机数字表法分为对照组31例与观察组31例。对照组服用格列美脲片治疗;观察组服用格列美脲片,临睡前加格列吡嗪缓释胶囊。2组疗程均为12周。比较2组的疗效,治疗前后糖代谢和脂代谢水平变化,及不良反应发生情况。结果观察组总有效率(94%)高于对照组(68%)(P<0.05)。2组治疗后糖化血红蛋白(HbA1c)、空腹胰岛素(FINS)和空腹血糖(FPG)较治疗前降低(观察组:t=12.791、15.352、12.697,对照组:t=10.058、15.644、11.505,P<0.05);观察组治疗后HbA1c、FINS和FPG低于对照组(t=6.468、6.422、0.566,P<0.05)。2组治疗后高密度脂蛋白胆固醇(HDL-C)较治疗前升高,而总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)和甘油三酯(TG)较治疗前降低(观察组:t=12.452、10.536、12.525、11.210,对照组:t=7.246、7.433、5.628、7.763,P<0.05);观察组治疗后HDL-C高于对照组,而TC、LDL-C和TG低于对照组(t=7.206、5.604、5.970、6.131,P<0.05)。2组治疗期间药物不良反应发生率比较差异无统计学意义(P>0.05)。结论长短效磺脲类药物联合治疗2型糖尿病患者的疗效良好,且不良反应少,安全性良好,值得临床借鉴。

Objective To investigate the efficacy and adverse reactions of long-acting and short-acting sulfonylureas in the treatment of type 2 diabetes mellitus.Methods Sixty-two patients with type 2 diabetes on treatment were randomly divided into the control group and study group(n=31 each).The control group was treated with glimepiride tablets.In addition,the study group was given glipizide sustained-release capsules at bedtime.Both groups were treated for 12 weeks.The therapeutic efficacy,changes of glucose metabolism and lipid metabolism at baseline and after the treatment,and the occurrence of adverse reactions were compared between the two groups.Results The total effective rate in the study group was higher than that in the control group(94%vs 68%,P<0.05).After the treatment,the levels of glycosylated hemoglobin(HbA1c),fasting insulin(FINS)and fasting plasma glucose(FPG)in the two groups decreased compared with baseline(study group:t=12.791,15.352,12.697;control group:t=10.058,15.644,11.505,all P<0.05).After the treatment,the levels of HbA1c,FINS and FPG in the study group were lower than those in the control group(t=6.468,6.422,0.566,all P<0.05).After the treatment,the level of high-density lipoprotein cholesterol(HDL-C)in the two groups increased compared with baseline,whereas the levels of total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),and triglyceride(TG)decreased compared with baseline(study group:t=12.452,10.536,12.525,11.210;control group:t=7.246,7.433,5.628,7.763,all P<0.05).After the treatment,the level of HDL-C in the study group was higher than that in the control group,whereas the levels of TC,LDL-C and TG were lower than those in the control group(t=7.206,5.604,5.970,6.131,all P<0.05).There was no statistically significant difference in the incidence of adverse drug reactions between the two groups(P>0.05).Conclusion Long-acting and short-acting sulfonylureas are effective in the treatment of type 2 diabetes mellitus,with less adverse reactions and good safety,which is recommendable for use in clinical practices for reference.