西格列汀二甲双胍治疗初诊断2型糖尿病的临床观察(1)
[摘要] 目的 观察用西格列汀二甲双胍片治疗初诊断2型糖尿病的有效性和安全性。方法 将2015年1月—2016年10月收治的40例新诊断2型糖尿病患者按照HbA1c水平分为A、B两组，采用二肽基肽酶-4(DPP-4)西格列汀二甲双胍复方制剂(50 mg西格列汀/500 mg盐酸二甲双胍)治疗，持续治疗30周。 结果 治疗24周后，空腹血糖，餐后2 h血糖、BMI、胰岛素释放水平与治疗前比较差异有统计学意义(P<0.05)，血脂、肝肾功与治疗前比较差异无统计学意义(P>0.05)。无低血糖事件，未发生其它不良反应。结论 西格列汀二甲双胍治疗初诊断2型糖尿病患者，可有效降低HbA1c及4个时点血糖(空腹及三餐后2 h血糖)。
[关键词] 初诊断2型糖尿病；西格列汀；二甲双胍片；HbA1c
[中图分类号] R59 [文献标识码] A [文章编号] 1672-4062(2018)07(a)-0087-03
Clinical Observation on Sitagliptin Plus Metformin in Treatment of Patients Initially Diagnosed with Type 2 Diabetes
ZHOU Jia-li， ZHANG Jian-wei
Department of endocrinology， Kunming First People’s Hospital， Kunming， Yunnan Province， 650011 China
[Abstract] Objective To observe the effectiveness and safety of sitagliptin plus metformin in treatment of patients initially diagnosed with type 2 diabetes. Methods 40 cases of patients with type 2 diabetes were divided into the group A and group from January 2015 to October 2016 according to the HbA1c level， treated with dipeptidyl peptidase- 4(DPP-4)sitagliptin plus metformin compound preparation (50 mg sitagliptin/500 mg metformin hydrochloride)， for 30 weeks in a row. Results After 24 weeks， the differences in the fasting blood glucose， postprandial 2 h blood glucose， BMI， insulin release level before and after treatment were statistically significant(P<0.05)， and the differences in the blood liquid， liver and renal functions before and after treatment were not statistically significant(P>0.05)， without the hypoglycemia events and other adverse reactions. Conclusion The sitagliptin plus metformin in treatment of patients initially diagnosed with type 2 diabetes can effectively reduce the HbA1c and blood glucose levels at four time points (fasting blood glucose and postprandial 2 h blood glucose).
[Key words] Initially diagnosed with type 2 diabetes； Sitagliptin； Metformin； HbA1c
進食或摄入葡萄糖后肠道分泌肽类激素参与糖代谢的调节，此类激素称为“incretins”(肠促胰素)。肠促胰素促进胰岛B细胞分泌胰岛素并抑制A细胞胰升糖素的释放，还有其他生物学作用。目前已知的肠促抑素有2种，其中胰升糖素样肽1(GLP-1)的作用强于GIP。但GLP-1的半寿期甚短，进入血液循环后迅速被二肽基肽酶-4(dipeptidyl-peptidase 4 DPP-4)降解。DPP-4抑制剂依赖内源性促肠胰岛肠肽分泌，DPP-4被抑制后，内源性GLP-1的降解明显延缓，血中GLP-1的浓度升高，至进于正常人水平，改善血糖水平[1]。在2型糖尿病中，GLP-1的分泌功能低下，经DPP-4抑制作用后，内源性活性GLP-1水平最多可达到高生理范围。由于其效果依赖内源性GLP-1，故适用于较早期糖尿病患者。新诊断2型糖尿病患者在诊断糖尿病之前，高血糖已存在多年，胰岛B细胞是一逐渐衰减的的过程[2-3]。在糖尿病的治疗方案中，“肠促胰素”概念的兴起为糖尿病临床治疗翻开了新篇章。联合二甲双胍可直击2型糖尿病的作用缺陷-胰岛素分泌不足、胰岛素抵抗，为2型糖尿病患者提供了一个优化治疗选择。该研究选取2015年1月—2016年10月收治患者40例，旨在观察二肽基肽酶-4(DPP-4)抑制剂西格列汀和二甲双胍复方制剂治疗初诊断2型糖尿病的有效性及安全性，现报道如下。, 百拇医药(周珈莉 张建伟)
[关键词] 初诊断2型糖尿病；西格列汀；二甲双胍片；HbA1c
[中图分类号] R59 [文献标识码] A [文章编号] 1672-4062(2018)07(a)-0087-03
Clinical Observation on Sitagliptin Plus Metformin in Treatment of Patients Initially Diagnosed with Type 2 Diabetes
ZHOU Jia-li， ZHANG Jian-wei
Department of endocrinology， Kunming First People’s Hospital， Kunming， Yunnan Province， 650011 China
[Abstract] Objective To observe the effectiveness and safety of sitagliptin plus metformin in treatment of patients initially diagnosed with type 2 diabetes. Methods 40 cases of patients with type 2 diabetes were divided into the group A and group from January 2015 to October 2016 according to the HbA1c level， treated with dipeptidyl peptidase- 4(DPP-4)sitagliptin plus metformin compound preparation (50 mg sitagliptin/500 mg metformin hydrochloride)， for 30 weeks in a row. Results After 24 weeks， the differences in the fasting blood glucose， postprandial 2 h blood glucose， BMI， insulin release level before and after treatment were statistically significant(P<0.05)， and the differences in the blood liquid， liver and renal functions before and after treatment were not statistically significant(P>0.05)， without the hypoglycemia events and other adverse reactions. Conclusion The sitagliptin plus metformin in treatment of patients initially diagnosed with type 2 diabetes can effectively reduce the HbA1c and blood glucose levels at four time points (fasting blood glucose and postprandial 2 h blood glucose).
[Key words] Initially diagnosed with type 2 diabetes； Sitagliptin； Metformin； HbA1c
進食或摄入葡萄糖后肠道分泌肽类激素参与糖代谢的调节，此类激素称为“incretins”(肠促胰素)。肠促胰素促进胰岛B细胞分泌胰岛素并抑制A细胞胰升糖素的释放，还有其他生物学作用。目前已知的肠促抑素有2种，其中胰升糖素样肽1(GLP-1)的作用强于GIP。但GLP-1的半寿期甚短，进入血液循环后迅速被二肽基肽酶-4(dipeptidyl-peptidase 4 DPP-4)降解。DPP-4抑制剂依赖内源性促肠胰岛肠肽分泌，DPP-4被抑制后，内源性GLP-1的降解明显延缓，血中GLP-1的浓度升高，至进于正常人水平，改善血糖水平[1]。在2型糖尿病中，GLP-1的分泌功能低下，经DPP-4抑制作用后，内源性活性GLP-1水平最多可达到高生理范围。由于其效果依赖内源性GLP-1，故适用于较早期糖尿病患者。新诊断2型糖尿病患者在诊断糖尿病之前，高血糖已存在多年，胰岛B细胞是一逐渐衰减的的过程[2-3]。在糖尿病的治疗方案中，“肠促胰素”概念的兴起为糖尿病临床治疗翻开了新篇章。联合二甲双胍可直击2型糖尿病的作用缺陷-胰岛素分泌不足、胰岛素抵抗，为2型糖尿病患者提供了一个优化治疗选择。该研究选取2015年1月—2016年10月收治患者40例，旨在观察二肽基肽酶-4(DPP-4)抑制剂西格列汀和二甲双胍复方制剂治疗初诊断2型糖尿病的有效性及安全性，现报道如下。, 百拇医药(周珈莉 张建伟)