达格列净与沙格列汀在老年2型糖尿病患者中的应用

Application of daglipzin and saxagliptin in elderly patients with type 2 diabetes mellitus

目的:探讨达格列净与沙格列汀对老年2型糖尿病患者炎症指标和肾功能的影响。方法:选取2021年1月—2021年8月收治的老年2型糖尿病患者200例,按随机数字表法分为对照组和观察组,每组100例。两组均应用二甲双胍治疗,在此基础上,对照组应用沙格列汀治疗,观察组应用达格列净治疗,比较两组治疗效果。结果:治疗前两组空腹血糖(FPG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(MOMA-IR)水平比较,差异无统计学意义(P>0.05);治疗后观察组FPG,HbA1c,HOMA-IR水平均低于对照组,差异有统计学意义(P<0.05)。治疗前两组甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)水平比较,差异无统计学意义(P>0.05)。治疗后观察组TG,TC水平低于对照组,差异有统计学意义(P<0.05);LDL-C,HDL-C水平与对照组比较,差异无统计学意义(P>0.05)。治疗前两组血肌酐(Scr)、尿素氮(BUN)、肾小球滤过率(eGFR)水平比较,差异无统计学意义(P>0.05);治疗后观察组Scr,BUN水平低于对照组,差异有统计学意义(P<0.05);eGFR水平与对照组比较,差异无统计学意义(P>0.05)。治疗前两组白细胞介素-6(IL-6)、C反应蛋白(CRP)、肿瘤细胞坏死因子-α(TNF-α)水平比较,差异无统计学意义(P>0.05);治疗后观察组IL-6,CRP,TNF-α水平均低于对照组,差异有统计学意义(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:二甲双胍联合达格列净治疗老年2型糖尿病患者,疗效优于二甲双胍联合沙格列汀。

Objective:To investigate the effects of dapagliflozin and saxagliptin on inflammatory markers and renal function in elderly patients with type 2 diabetes mellitus.Methods:A total of 200 elderly patients with type 2 diabetes mellitus from January to August 2021 were selected as the research objects.They were divided into control group and observation group by random number table method,with 100 cases in each group.The control group was treated with saxagliptin,and the observation group was treated with dapagliflozin.The therapeutic effects of the two groups were compared.Results:Before treatment,there were no statistically significant differences in the levels of fasting plasma glucose(FPG),glycosylated hemoglobin(HbA1c),and insulin resistance index(MOMA-IR) between the observation group and the control group(P>0.05).After treatment,the levels of FPG,HbA1c and HOMA-IR in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Before treatment,the levels of triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C) and high density lipoprotein cholesterol(HDL-C) in the observation group were not significantly different from those in the control group(P>0.05).After treatment,the TG and TC levels of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of LDL-C and HDL-C in the observation group were not significantly different from those in the control group(P>0.05).Before treatment,the levels of serum creatinine(Scr),blood urea nitrogen(BUN) and glomerular filtration rate(eGFR) in the observation group were not significantly different from those in the control group(P>0.05).After treatment,the levels of Scr and BUN in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in eGFR level between the observation group and the control group after treatment(P>0.05).Before treatment,the levels of interleukin-6(IL-6),C-reactive protein(CRP) and tumor cell necrosis factor-α(TNF-α) in the observation group were not significantly different from those in the control group(P>0.05).After treatment,the levels of IL-6,CRP and TNF-α in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the observation group and the control group(P>0.05).Conclusions:Dapagliflozin combined with metformin can improve the therapeutic effect compared with saxagliptin in the treatment of elderly patients with type 2 diabetes.