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维格列汀联合二甲双胍对超重2型糖尿病病人代谢指标的影响 预览

Effect of vildagliptin combined with metformin on metabolic index in patients with overweight type 2 diabetes
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摘要 目的观察维格列汀与二甲双胍联合应用对超重2型糖尿病病人代谢指标的综合影响,评价其疗效。方法选取2013年12月至2016年10月中国人民解放军第三〇五医院收治单独应用二甲双胍(500mg,3次/天,服用3个月以上)血糖控制不佳的超重2型糖尿病病人120例,按随机数字表法分为观察组(60例)和对照组(60例)。对照组口服二甲双胍剂量增加至1000mg、2次/天;观察组予口服二甲双胍500mg、3次/天,并联用维格列汀50mg、2次/天,共24周。比较治疗前后体质量指数(BMI)、糖化血红蛋白(HbA1c)、空腹血糖(FBG)、餐后2h血糖(2hPBG)、总胆固醇(TC)、三酰甘油(TG)和低密度脂蛋白胆固醇(LDL-C)、同型半胱氨酸(Hcy)等指标的变化。结果治疗24周后,对照组FBG、2hPBG、HbA1c分别为(7.98±0.83)mmol/L、(12.25±0.90)mmol/L、(8.05±1.05)%,观察组分别为(7.09±0.80)mmol/L、(9.86±1.13)mmol/L、(7.01±0.88)%,两组FBG、2hPBG、HbA1c均较治疗前降低(P<0.05),观察组较对照组下降更明显(t值分别为:2.47、5.27、3.22,均P<0.05);治疗24周后,对照组BMI、TC、TG、LDL-C、Hcy分别为(27.60±3.70)kg/m2、(6.39±0.89)mmol/L、(2.77±0.40)mmol/L、(3.29±0.43)mmol/L、(17.4±2.03)mmol/L,观察组分别为(26.34±3.83)kg/m2、(5.31±0.72)mmol/L、(2.31±0.33)mmol/L、(2.92±0.44)mmol/L、(15.16±1.74)mmol/L,与治疗前比较,两组BMI、血脂、Hcy水平均显著下降(P<0.05),观察组下降更显著(t值分别为:2.14、3.50、2.26、2.21、3.27,均P<0.05)。两组不良反应发生率差异无统计学意义(χ^2=2.62,P>0.05)。结论 维格列汀联合二甲双胍能够有效控制肥胖或超重的2型糖尿病病人的血糖及BMI,并且能够改善血脂,降低血糖,且不增加低血糖风险,是超重或肥胖2型糖尿病病人有效治疗方案之一。 Objective To observed the effect of vildagliptin and metformin on metabolic index in patients with overweight type 2 diabetes,and to evaluate its curative effect.Methods One hundred and twenty patients with overweight type 2 diabetes mellitus with poor blood sugar control in The 305 Hospital of PLA from December 2013 to October 2016 were treated with metformin alone(dose of 500 mg,3/d,taking more than 3 months).The patients were assigned into observation group(60 cases)and control group(60 cases)by random number table method.Control group was given oral metformin(1 000 mg,2 times/d),while observation group was given oral metformin(500 mg,3 times/d)combined with vildagliptin(50 mg,2 times/d)for 24 weeks.The body mass index(BMI)before and after the treatment,glycated hemoglobin(HbA 1c),fasting blood glucose(FBG),2 h postprandial blood glucose(2 h PBG),total cholesterol(TC),triglyceride(TG)and low density lipoprotein cholesterol(LDL-C),homocysteine(Hcy),and other indicators of change were compared,and the adverse reaction occurred was observated.Results 24 weeks after treatment,FBG,2 h PBG,HbA 1c in the control group was(7.98±0.83)mmol/L,(12.25±0.90)mmol/L,and(8.05±1.05)%,respectively;the indexes in observation group were(7.09±0.80)mmol/L,(9.86±1.13)mmol/L and(7.01±0.88)%,respectively;FBG,2 h PBG,HbA 1c in two groups were reduced compared with before treatment(P<0.05),those indexes in the observation group were significantly decreased compared with the control group(t=2.47,5.27,3.22,all P<0.05);24 weeks after treatment,BMI,TC,TG,LDL-C,Hcy in the control were(27.60±3.70)kg/m 2,(6.39±0.89)mmol/L,(2.77±0.40)mmol/L,(3.29±0.43)mmol/L and(17.4±2.03)mmol/L,respectively;those indexes in the observation group were(26.34±3.83)kg/m 2,(5.31±0.72)mmol/L,(2.31±0.33)mmol/L,(2.92±0.44)mmol/L,(15.16±1.74)mmol/L,respectively;BMI,blood lipid,Hcy levels in the two groups were significantly decline compared with before treatment(P<0.05),those indexes in the observation group were significantly decreased compared with the
作者 曲建昌 王彤 李丽 梁艳玲 王莉莎 祝开思 QU Jianchang;WANG Tong;LI Li;LIANG Yanling;WANG Lisha;ZHU Kaisi(Department of Endocrinology,The 305 Hospital of PLA,Beijing 100017,China)
出处 《安徽医药》 CAS 2019年第4期819-822,共4页 Anhui Medical and Pharmaceutical Journal
关键词 糖尿病 2型 二甲双胍 血红蛋白A 糖基化 半胱氨酸 超重 维格列汀 Diabetes mellitus,type 2 Metformin Hemoglobin A,glycosylated Cysteine Overweight Vildagliptin
作者简介 通信作者:祝开思,男,主任医师,硕士生导师,研究方向为糖尿病、甲状腺、痛风等内分泌代谢性疾病,E-mail:sun_softwind@126.com.
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