摘要
目的探讨达格列净对2型糖尿病(T2DM)患者25-羟基维生素D_(3)[25(OH)D_(3)]、白细胞介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)表达的影响。方法选取2018年7月至2020年9月在该院治疗的138例T2DM患者作为研究对象,采用前瞻性、单盲、随机对照设计原则,通过随机数字表法将患者分为观察组和对照组,各69例。对照组行常规基础治疗,包括饮食指导、运动指导、甘精胰岛素及口服降糖药物,观察组在对照组治疗基础上加用达格列净治疗(起始剂量5 mg/d,根据血糖控制情况可增加至10 mg/d)。比较两组临床疗效、血糖水平,以及血清25(OH)D_(3)、IL-6、TNF-α水平。观察两组不良反应发生情况。结果治疗后观察组总有效率明显高于对照组(91.30%vs.69.56%,P<0.05)。两组治疗后空腹血糖(FPG)、2 h餐后血糖(2 h PBG)、糖化血红蛋白(HbA1c)、血清IL-6及TNF-α水平均较治疗前明显降低(P<0.05),且观察组治疗后FPG、2 h PBG、HbA1c、血清IL-6及TNF-α水平均明显低于对照组(P<0.05)。两组治疗后血清25(OH)D_(3)水平均较治疗前明显升高(P<0.05),且观察组治疗后血清25(OH)D_(3)水平明显高于对照组(P<0.05)。观察组总不良反应发生率与对照组无明显差异(15.94%vs.11.59%,P>0.05)。结论在常规治疗基础上加用达格列净可降低T2DM患者血糖水平,调节血清25(OH)D_(3)、IL-6及TNF-α水平,改善临床疗效,且不增加不良反应的发生。
Objective To investigate the effect of dapagliflozin on the expressions of 25-hydroxyvitamin D_(3)[25(OH)D_(3)],interleukin-6(IL-6)and tumor necrosis factor-α(TNF-α)in patients with type 2 diabetes mellitus(T2DM).Methods A total of 138 T2DM patients treated in this hospital from July 2018 to September 2020 were selected as the research subjects.The prospective,single-blind,and randomized controlled design principles were adopted.The patients were divided into the observation group and the control group by random number table method,with 69 cases in each group.The control group was treated with routine basic treatment,including dietary guidance,exercise guidance,insulin glargine and oral hypoglycemic drugs.The observation group was treated with dapagliflozin on the basis of the control group,the initial dose was 5 mg/d,which could be increased to 10 mg/d according to the blood glucose control.The clinical efficacy,blood glucose level,and serum 25(OH)D_(3),IL-6,and TNF-αlevels were compared between the two groups.The incidence of adverse reactions in the two groups was observed.Results The total effective rate of the observation group was significantly higher than that of the control group after treatment(91.30%vs.69.56%,P<0.05).The levels of fasting plasma glucose(FPG),2 h postprandial blood glucose(2 h PBG),glycosylated hemoglobin(HbA1c),serum IL-6 and TNF-αafter treatment were significantly decreased compared with those before treatment in both groups(P<0.05),and the levels of FPG,2 h PBG,HbA1c,serum IL-6 and TNF-αin theobservation group were significantly lower than those in the control group(P<0.05).After treatment,the serum 25(OH)D_(3) levels in the two groups were significantly higher than those before treatment(P<0.05),and the serum 25(OH)D_(3) level in the observation group after treatment was significantly higher than that in the control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the observation group and the control group(15.94%vs.11.59%,P>0.05).Conclusion Addition of dapagliflozin to conventional treatment can reduce the blood glucose level in patients with T2DM,regulate the serum levels of 25(OH)D_(3),IL-6 and TNF-α,and improve the clinical efficacy without increasing the incidence of adverse reactions.
作者
骆莹莹
黄若妃
李可
LUO Yingying;HUANG Ruofei;LI Ke(Department of Endocrinology,First People’s Hospital of Yongkang City,Yongkang,Zhejiang 321300,China)
出处
《重庆医学》
CAS
2022年第12期2024-2027,共4页
Chongqing medicine
基金
浙江省医药卫生科技计划项目(2019RC305)。
