摘要
目的:观察磷酸西格列汀联合阿卡波糖对老年2型糖尿病患者血糖、血脂及葡萄糖转运蛋白4(GLUT4)的影响。方法:86例2型糖尿病老年患者随机分为对照组和观察组,每组43例。两组患者均给予饮食、运动、生活规律等方面的指导,并进行心理及用药方面的护理。在此基础上,对照组患者给予阿卡波糖片50 mg/次,每日3次,餐时咀嚼服用;观察组患者给予阿卡波糖片(用法用量同对照组)+磷酸西格列汀片100 mg/次,每日1次,口服。两组疗程均为3个月。比较两组患者治疗前后的空腹血糖(FBG)、餐后2 h血糖(2 h PG)、糖化血红蛋白(Hb Alc)、体质量指数(BMI)、空腹胰岛素(FINs)、胰岛素抵抗指数(HOMA-IR)、胰岛B细胞功能指数(HOMA-B)、总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)等指标,同时记录治疗期间不良反应发生情况。此外,选取43名健康志愿者作为健康对照组,分别比较两组患者治疗前后血清GLUT4水平与健康对照组之间的差别。结果:治疗后,两组患者BMI、FBG、2 h PG、HbA_lc、HOMA-IR、FINs、TC、TG、LDL-C水平显著低于同组治疗前,且观察组显著低于对照组;两组患者HOMA-B、HDL-C水平显著高于同组治疗前,且观察组显著高于对照组,差异均有统计学意义(P<0.05)。治疗前,两组患者血清GLUT4水平显著低于健康对照组,差异有统计学意义(P<0.05)。治疗后,对照组患者血清GLUT4水平与治疗前比较差异无统计学意义(P>0.05),观察组患者血清GLUT4水平显著高于同组治疗前,亦显著高于同期对照组,但仍低于健康对照组,差异均有统计学意义(P<0.05)。两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论:磷酸西格列汀联合阿卡波糖治疗老年2型糖尿病能有效控制患者的血糖和血脂水平、改善胰岛B细胞的功能、提高血清GLUT4水平,且不增加不良反应的发生,安全性较好。
OBJECTIVE：To observe the effects of sitagliptin phosphate combine with acarbose on blood glucose,blood lipid and the serum glucose transporter 4（GLUT4）in elderly patients with type 2 diabetes. METHODS：86 elderly patients with type 2diabetes were randomly divided into control group and observation group,43 cases in each group. All patients received guidance about diet,exercise and living habits,etc.,as well as the care about psychology and medication. Based on it,control group was given Acarbose tablet 50 mg/times,tid,chewing when a meal;observation group was given Acarbose tablet（the same dosage and usage）＋ Sitagliptin phosphate tablet 100 mg/times,qd,orally. They were treated for 3 months. Fasting blood glucose（FBG）,2 h postprandial blood glucose（2 h PG）,glycosylated hemoglobin（Hb Alc）,body mass index（BMI）,fasting insulin（FINs）,insulin resistance index（HOMA-IR）,islet B-cell function index（HOMA-B）,total cholesterol（TC）,triglyceride（TG）,low-density lipoprotein cholesterol（LDL-C）,high-density lipoprotein cholesterol（HDL-C）before and after treatment in 2 groups were compared,the incidence of adverse reactions was recorded. Other 43 healthy people were selected as healthy control group,the differences of serum GLUT4 levels before and after treatment between the 2 groups and healthy control group were respectively compared. RESULTS：After treatment,the BMI,FBG,2 h PG,Hb_ Alc,HOMA-IR,FINs,TC,TG and LDL-C level were significantly lower than before,observation group was lower than control group;HOMA-B and HDL-C level were significantly higher than before,observation group was higher than control group,with statistical significance（P〈0.05）. Before treatment,the serum GLUT4 level in2 groups were significant lower than healthy control group with satistical significance（P〈0.05）;after treatment,the serum GLUT4 level in control group there was no significant different than before（P〉0.05）,while the serum GLUT4 level in observation group was significant higher than before and control group;and the serum GLUT4 level in 2 groups were still significant lowerthan healthy control group（P〈0.05）. And there was no significant difference in the incidence of adverse reactions（P〉0.05）. CONCLUSIONS：Sitagliptin phosphate combine with acarbose can effectively control patients’ blood glucose and lipid levels in the treatment of elderly patients with type 2 diabetes,improve HOMA-B and serum GLUT4 level,and does not increase the incidence of adverse reactions,with good safety.
出处
《中国药房》
CAS
北大核心
2017年第9期1204-1207,共4页
China Pharmacy
