337例门诊2型糖尿病慢病患者用药安全监控和病例分析

Drug safety monitoring and case analysis of 337 outpatients with chronic type 2 diabetes mellitus

目的 分析2型糖尿病慢病患者用药安全性与临床效果。方法 337例2型糖尿病慢病患者,根据不同治疗方式将其分为A组(168例)、B组(169例)。A组患者仅给予单一的二甲双胍治疗,B组患者接受二甲双胍与达格列净联合治疗。比较两组患者治疗前后血糖[空腹血糖(FBG)、餐后2 h血糖(2 h PBG)、平均血糖水平(MBG)]水平、动态血糖监测系统(CGMS)检测结果[达标时间、血糖标准差(SDBG)、日内平均血糖波动幅度(MAGE)、全天血糖波动次数(NGE)、日间血糖平均绝对差(MODD)]、低血糖事件发生情况。结果 治疗后,两组患者FBG、2 h PBG、MBG水平均较治疗前下降,且B组患者FBG(6.31±1.5)mmol/L、2 h PBG(8.1±2.8)mmol/L、MBG(6.0±1.3)mmol/L均低于A组的(7.02±1.5)、(9.3±3.0)、(7.2±1.5)mmol/L,差异均具有统计学意义(P<0.05)。B组患者CGMS达标时间(5.1±1.2)d短于A组的(6.5±1.4)d, SDBG(2.1±0.8)mmol/L、MAGE(3.8±1.4)mmol/L、NGE(4.1±1.5)次/d、MODD(1.5±0.7)mmol/L均低于A组的(2.5±0.7)mmol/L、(5.1±1.6)mmol/L、(4.6±1.4)次/d、(2.4±0.8)mmol/L,差异均具有统计学意义(P<0.05)。A组中有28例出现低血糖,低血糖事件发生率为16.7%,B组中有9例出现低血糖,低血糖事件发生率为5.3%, B组低血糖发生率低于A组,差异具有统计学意义(P<0.05)。结论 2型糖尿病慢病患者采取二甲双胍与达格列净治疗临床效果好,安全性高。

Objective To analyze the drug safety and clinical effect of patients with chronic type 2 diabetes mellitus.Methods A total of 337 patients with chronic type 2 diabetes mellitus were divided into group A(168 cases)and group B(169 cases)according to different treatment methods.Patients in group A were only treated with metformin alone,and patients in group B were treated with metformin in combination with dapagliflozin.Both groups were compared in terms of blood glucose[fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG),mean blood glucose(MBG)]levels before and after treatment,continuous glucose monitoring system(CGMS)test results[standard-reaching time,standard deviation of blood glucose(SDBG),mean amplitude of glycemic excursions(MAGE),number of glycemic excursion(NGE),absolute means of daily differences(MODD)],and occurrence of hypoglycemic events.Results After treatment,the levels of FBG,2 h PBG and MBG decreased in both groups compared with those before treatment in this group;the FBG(6.31±1.5)mmol/L,2 h PBG(8.1±2.8)mmol/L,and MBG(6.0±1.3)mmol/L in group B were lower than(7.02±1.5),(9.3±3.0),and(7.2±1.5)mmol/L in group A;the differences were all statistically significant(P<0.05).The CGMS reaching standard time(5.1±1.2)d of group B was shorter than(6.5±1.4)d of group A;the SDBG(2.1±0.8)mmol/L,MAGE(3.8±1.4)mmol/L,NGE(4.1±1.5)times/d,MODD(1.5±0.7)mmol/L of group B were lower than(2.5±0.7)mmol/L,(5.1±1.6)mmol/L,(4.6±1.4)times/d,(2.4±0.8)mmol/L of group A;the differences were all statistically significant(P<0.05).In group A,there were 28 cases of hypoglycemia in group A,and the incidence of hypoglycemia was 16.7%;in group B,there were 9 cases of hypoglycemia in group B,and the incidence of hypoglycemia was 5.3%.The incidence of hypoglycemia in group B was lower than that in group A,the difference was statistically significant(P<0.05).Conclusion Metformin combined with dapagliflozin is effective and safe in the treatment of patients with chronic type 2 diabetes mellitus.