格列美脲联合二甲双胍对2型糖尿病50例疗效及胰岛功能的影响

Effects of Glimepiride Combined with Metformin on the Efficacy and Islet Function of 50 Cases of Patients with Type 2 Diabetes Mellitus

目的 研究格列美脲联合二甲双胍治疗2型糖尿病(T2DM)患者的疗效及对胰岛功能的影响。方法 以2021年1月至2022年9月周口市人民医院收治的100例T2DM患者为研究对象,采用随机数字表法分为对照组和联合组,各50例。对照组采用二甲双胍治疗,联合组采用格列美脲联合二甲双胍治疗。比较两组临床疗效,治疗前及治疗12周后血糖[空腹血糖(FPG)、餐后2 h血糖(2 hPG)],血尿酸及尿微量蛋白(MAU)水平、胰岛功能指标[胰岛素抵抗指数(HOMA-IR)、胰岛β细胞功能指数(HOMA-β)、空腹胰岛素(FINS)],血清脂肪酸结合蛋白4(FABP4),葡萄糖转运蛋白4(GLUT4),超氧化物歧化酶(SOD),丙二醛(MDA)水平及不良反应发生率。结果 联合组临床总有效率(98.00%)高于对照组(84.00%),(P<0.05)。治疗12周后联合组FPG、2 hPG、血尿酸、MAU水平低于对照组(P<0.05);联合组HOMA-IR、FINS低于对照组,HOMA-β高于对照组(P<0.05);联合组血清FABP4、MDA水平低于对照组,GLUT4、SOD水平高于对照组(P<0.05)。联合组不良反应发生率(12.00%)与对照组(6.00%)比较,差异无统计学意义(P>0.05)。结论 格列美脲联合二甲双胍治疗T2DM患者可显著提高临床疗效,抑制氧化应激反应,有效增强胰岛功能,降低血糖水平。

Objective To study the efficacy of glimepiride combined with metformin in the treatment of patients with type 2 diabetes mellitus(T2DM)and the effect on their islet function.Methods One hundred patients with T2DM admitted to Zhoukou People's Hospital from January 2021 to September 2022 were studied,and were divided into a control group and a combination group using the random number table method,with 50 cases each.The control group was treated with metformin and the combination group was treated with glimepiride combined with metformin.The clinical efficacy,blood glucose[fasting blood glucose(FPG),2 h postprandial blood glucose(2 hPG)],blood uric acid and urinary microprotein(MAU)levels,islet function index[insulin resistance index(HOMA-IR),isletβ-cell function index(HOMA-β),fasting insulin(FINS)],serum fatty acid binding protein 4(FABP4),glucose transfer protein 4(GLUT4),and superoxide dismutase(SOD),malondialdehyde(MDA)levels and the incidence of adverse effects were compared between the two groups before and after 12 weeks of treatment.Results The total clinical efficiency of the combined group(98.00%)was higher than that of the control group(84.00%)(P<0.05).After 12 weeks of treatment,the FPG,2 hPG,Blood uric acid and MAU levels of the combined group were lower than those of the control group after 12 weeks of treatment(P<0.05);the HOMA-IR and FINS of the combined group were lower than those of the control group and the HOMA-βwas higher than that of the control group after 12 weeks of treatment(P<0.05).After 12 weeks of treatment,serum FABP4 and MDA levels in the combined group were lower than those in the control group,GLUT4 and SOD levels were higher than those in the control group(P<0.05).There was no significant difference(P>0.05)in the incidence of adverse reactions in the combined group(12.00%)compared with that in the control group(6.00%).Conclusion Glimepiride combined with metformin in the treatment of T2DM patients can significantly improve clinical efficacy,inhibit oxidative stress,effectively enhance islet function and reduce blood glucose levels.