海南医科大学学报

目的:研究初诊2型糖尿病应用西格列汀与二甲双胍治疗对血糖波动及微炎症状态的影响。方法:2014年1月~2015年12月期间收集重庆市长寿区人民医院确诊的初诊2型糖尿病患者168例,随机分为观察组与对照组2组,观察组予西格列汀(捷诺维,100mg,1次/d)对照组予二甲双胍(格华止,0.5g,2次/d),每2周根据血糖水平调整用药,仍不能控制血糖达标,则加用阿卡波糖(拜糖平)0.5g,3次/d,血糖达标后维持,总观察研究时间6月。比较2组的HbA1c、BMI、胰岛素抵抗指数、血糖波动指标、循环炎症因子指标。结果:观察组治疗后与对照组治疗后相比较,PPGE、MAGE、MODD差异均具有统计学意义(均P<0.05)。观察组治疗后与对照组相比较IL-6、TNF-α差异均具有统计学意义(均P<0.05)。结论:初诊2型糖尿病应用西格列汀不仅能够与二甲双胍同样能够控制血糖,而且能更好降低血糖波动,抑制循环微炎症状态。

Objective:To investigate the influence of stigliptin and metformin treatment on glucose fluctuation and serum inflammatory factors in preliminary diagnosed Type 2diabetes mellitus.Methods:From January 2014 to December 2015,168 cases of patients with newly diagnosed Type 2diabetes mellitus were recruited and divided randomly into observation group and control group.The observation group was given sitgliptin(Januvia,100 mg per d),while the control group was given metformin(Glucophage tablet,initial dose 0.5g bid,twice per d),and the dosage of drugs was adjusted every 2weeks according to glucose level.If the glucose level still wasn't controlled to reach the normal standard by maximum dosage of drugs,0.5g bid of acarbose(Glucobay)was applied for the treatment 3times one day till the glucose level reached the normal standard and the observation was kept for 6 months.The HbA1 c,BMI,fluctuation indexes,and serum inflammatory factors of two groups were compared.Results:After the treatment of control group and observation group,the differences of PPGE(t=8.425,P=0.012),MAGE(t=7.348,P=0.014)and MODD(t=9.327,P=0.010)between two groups were significant(P<0.05).The differences of IL-6(t=6.337,P=0.010)and TNF-α(t=6.521,P=0.011)level of observation group and control group after treatment were statistical significant(P<0.05).Conclusions:The sitgliptin could not only achieve glycemic control goal as metformin,but also induce glucose fluctuation and inhibit serum inflammation better.