沙格列汀联合二甲双胍治疗老年2型糖尿病患者的效果

Effects of Saxagliptin combined with Metformin in treatment of elderly patients with type 2 diabetes mellitus

目的:观察沙格列汀联合二甲双胍治疗老年2型糖尿病(T2DM)患者的效果。方法:选取300例老年T2DM患者为研究对象,按照抽签法分为二甲双胍组、沙格列汀组、沙格列汀联合二甲双胍组,每组100例。二甲双胍组给予二甲双胍治疗,沙格列汀组给予沙格列汀治疗,沙格列汀联合二甲双胍组给予沙格列汀联合二甲双胍联合治疗。比较三组血糖[空腹血糖(FPG)、餐后2 h血糖(P2 hPG)、糖化血红蛋白(HbAlc)]水平、胰岛素功能相关指标[空腹胰岛素(FINS)、胰岛素分泌指数(HOMA-B)]水平、炎性因子[C反应蛋白(CRP)、白细胞介素6(IL-6)、血脂肪酶(LPS)]水平及不良反应发生率。结果:治疗后,三组FPG、P2 hPG、HbAlc、CRP、IL-6及LPS水平均明显低于治疗前,且沙格列汀联合二甲双胍组明显低于另两组,差异有统计学意义(P<0.05);治疗后,三组FINS、HOMA-B水平均明显高于治疗前,且沙格列汀联合二甲双胍组明显高于另两组,差异有统计学意义(P<0.05);三组用药后的低血糖反应、消化道症状发生率比较,差异均无统计学意义(P>0.05)。结论:沙格列汀联合二甲双胍治疗老年T2DM患者可提高FINS和HOMA-B水平,降低血糖水平和炎性因子水平,效果优于单纯沙格列汀治疗效果或二甲双胍治疗效果。

Objective:To study the clinical effect of Saxagliptin combined with Metformin in treatment of elderly patients with type 2 diabetes mellitus(T2DM).Methods:300 elderly T2DM patients were selected as the research objects,and were divided into Metformin group,Saxagliptin group,Saxagliptin combined with Metformin group according to the lottery method,100 cases in each group.The Metformin group was given Metformin,the Saxagliptin group was given Saxagliptin,while the Saxagliptin combined with Metformin group used Saxagliptin combined with Metformin.Then,the blood glucose levels[fasting blood glucose(FPG),2 hour postprandial blood glucose(P2 hPG),glycated hemoglobin(HbAlc)]levels,insulin function related indicator[fasting insulin(FINS),insulin secretion index(HOMA-B)]levels,inflammatory factor[C-reactive protein(CRP),interleukin 6(IL-6),blood lipase(LPS)]levels and incidence of adverse reactions were compared among the three groups.Results:After the treatment,the levels of FPG,P2 hPG,HbAlc,CRP,IL-6 and LPS in the three groups were significantly lower than those before the treatment;those of the Saxagliptin combined with Metformin group were significantly lower than those of the other two groups;and the differences were statistically significant(P<0.05).After the treatment,the levels of FINS and HOMA-B in the three groups were significantly higher than those before the treatment;those of the Saxagliptin combined with Metformin group were significantly higher than those of the other two groups;and the differences were statistically significant(P<0.05).However,there were no statistically significant differences in the hypoglycemic reaction and the incidence of gastrointestinal symptoms after medication among the three groups(P>0.05).Conclusions:Saxagliptin combined with Metformin in the treatment of the elderly T2DM patients can increase the fasting insulin levels and insulin secretion index levels,and reduce the blood glucose levels and the inflammatory factors.Moreover,it is superior to single Saxagliptin or Metformin.