摘要
目的 观察西格列汀治疗老年2型糖尿病的有效性和安全性.方法 选择我院内分泌科2010年4月-2012年12月收治的2型糖尿病患者95例,年龄60～96岁,平均（76.6±8.8）岁;2型糖尿病病程1～30年,平均（8.5±5.6）年;初始降糖治疗即采用西格列汀6例,因血糖控制不达标而加用西格列汀38例,采用西格列汀替换原口服降糖药51例;西格列汀服用方法：100 mg/次口服,1次/d.观察所有患者服用西格列汀前后各项指标变化,观察时间为1～30个月,平均为（10.7±8.6）个月.观察指标包括BMI、收缩压、舒张压、空腹血糖、糖化血红蛋白（HbA1c）、尿酸、TC、TG、HDL-C、LDL-C、ALT、AST、血肌酐、肌酸激酶（CK）、乳酸脱氢酶（LDH）、α羟基丁酸脱氢酶（HBDH）及血尿常规等,同时记录患者用药不良反应.结果 本组95例患者服用西格列汀后,空腹血糖、HbA1c、尿酸、TC、LDL-C、血肌酐、LDH较服用西格列汀前降低,HDL-C较服用西格列汀前升高（P＜0.05）;余观察指标比较,差异均无统计学意义（P＞0.05）.所有患者血尿常规未见明显异常.不良反应：无因西格列汀不良反应停药者,无一例患者原有疾病加重或住院,3例患者服用西格列汀后血糖控制不达标,停用西格列汀而改用其他降糖药.结论 西格列汀具有良好的降糖效果,并有利于改善患者血脂,对患者肝肾功能无明显不良影响,适用于合并多种疾病、联用多种药物的老年2型糖尿病患者,与常用降糖药、降压药、降脂药、抗凝药等联合应用较为安全.
Objective To observe the effect and safety of sitagliptin on type 2 diabetes mellitus （T2DM） in elderly patients. Methods 95 T2DM patients admitted to the Department of Endocrinology of our hospital from April 2010 to December 2012 were selected. The patients were aged from 60 to 96, averaging （76. 6 ± 8.8 ）, and had T2DM courses from one to 30 years, averaging （8. 5 ±5.6） years. Sitagliptin was used in 6 cases for the initial hypoglycemic therapy, and another 38 cases were given sitagliptin after unsatisfactory blood glucose control. 51 cases replaced their oral hypoglycemic drugs by sitaglip- tin. Sitagliptin was taken 100 mg per time, one time per day. The indexes of the patients before and after taking sitagliptin were observed for one to 30 months, with an average of （ 10. 7 ± 8.6） months. The indexes included BMI, SBP, DBP, FBG, HbA1c, UA, TC, TG, HDL-C, LDL-C, ALT, AST, Cr, CK, LDH, HBDH, blood and urine routine test and records of adverse reactions. Results Among the 95 patients after taking sitagliptin, the FBG, HbA1c, UA, TC, LDL - C, Cr and LDH were decreased, while the HDL - C was increased （P 〈 0. 05 ） . The other indexes showed no statistically significant differ- ence （ P 〉 0. 05） . No abnormalities were found in the blood and urine routine tests. No adverse reactions were found among the patients, and no patient aggravated their conditions. 3 cases had unsatisfactory blood glucose control and turned to other hypogly- cemic drugs. Conclusion Sitagliptin can effectively reduce blood glucose level, and can also improve the patients＇blood lipid level without obvious adverse reactions from the liver and kidney. Sitagliptin is safe when used with other hypoglycemic drugs, hy- potensive drugs, lipid - lowering drugs and anticoagulant drugs, and therefore it is suitable for elderly patients with T2DM com- plicated with many other diseases.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第6期686-688,共3页
Chinese General Practice
关键词
糖尿病
2型
老年人
西格列汀
二肽基肽酶Ⅳ抑制剂
Diabetes meUitus, type 2
Aged
Sitagliptin
Dipeptidyl peptidese Ⅳ inhibitors
