摘要
目的 探讨二肽基肽酶4(DPP4)抑制剂对血糖控制不佳的2型糖尿病(T2DM)患者的疗效及对复合非致命性心血管事件的影响。方法 选取2021年2月至2023年2月在武警第一机动总队医院及武警第二机动总队医院内分泌科采用二甲双胍+阿卡波糖治疗效果不佳的T2DM患者130例作为研究对象,采用随机数字表法分为DPP4组(二甲双胍+阿卡波糖+DPP4抑制剂)和胰岛素组(二甲双胍+阿卡波糖+胰岛素),各65例,均连续治疗12个月。观察2组血糖指标、血脂指标、氧化应激指标变化及非致命性心血管事件发生情况。结果 DPP4组患者非致命性心血管事件发生率低于胰岛素组,差异具有统计学意义(P <0.05)。2组治疗后空腹血糖(FPG)、餐后2 h血糖(2hPG)、糖化血红蛋白(HbA1c)、胰岛素抵抗指数(HOMA-IR)、甘油三酯(TG)、总胆固醇(TC)、丙二醛(MDA)、过氧化脂质(LPO)、活性氧(ROS)水平均较治疗前降低(P <0.05),且DPP4组治疗后MDA、ROS水平均低于胰岛素组,比较差异均有统计学意义(P <0.05)。2组治疗后高密度脂蛋白胆固醇(HDL-C)、谷胱甘肽过氧化物酶(GSH-Px)水平均较治疗前升高,且DPP4组治疗后GSH-Px高于胰岛素组,差异均有统计学意义(P <0.05)。结论 二甲双胍+阿卡波糖治疗后血糖控制不佳的T2DM患者联合应用DPP4抑制剂与胰岛素的效果相近,但是前者更有利于改善患者的氧化应激状态,并可降低非致命性心血管事件发生率。
Objective To investigate the effect of dipeptidyl peptidase 4(DPP4)inhibitor on blood glucose control and the incidence of combined non-fatal cardiovascular events in type 2 diabetes patients with poor response to metformin+acarbose treatment.Methods A total of 130 cases of T2DM patients who responded poorly to metformin+acarbose in the Endocrinology Department of the First Mobile Corps Hospital of People's Armed Police and the Second Mobile Corps Hospital of People's Armed Police from February 2021 to February 2023 were selected as the study subjects.They were randomly divided into the DPP4 group(metformin+acarbose+DPP4 inhibitor)and the insulin group(metformin+acarbose+insulin)using a random number table,with 65 patients in each group.All patients were continuously treated and observed for 12 months.Results The incidence of non-fatal cardiovascular events in the DPP4 group was significantly lower than that in the insulin group,he difference was statistically significant.(P<0.05).Post-treatment fasting blood glucose,2-hour postprandial blood glucose,glycated hemoglobin,insulin resistance index,triglycerides,total cholesterol,malondialdehyde(MDA),lipid peroxidation,and reactive oxygen species(ROS)levels were reduced in both groups(P<0.05),with MDA and ROS levels in the DPP4 group being significantly lower than in the insulin group(P<0.05).High-density lipoprotein cholesterol and glutathione peroxidase(GSH-Px)levels were significantly increased in both groups after treatment(P<0.05),and GSH-Px levels in the DPP4 group were higher than those in the insulin group(P<0.05).Conclusion The efficacy of DPP4 inhibitors combined with metformin and acarbose in T2DM patients with poor blood glucose control is similar to that of insulin.However,the former is more effective in improving oxidative stress and reducing the incidence of non - fatal cardiovascular events.
作者
欧阳海燕
郑晓红
李怡然
耿瑞慧
OUYANG Haiyan;ZHENG Xiaohong;LI Yiran;GENG Ruihui(Management Department of Military Wounded and Sick Personnel,The First Mobile Corps Hospital of the People's Armed Police Force,Dingzhou Hebei 073000,China;Department of Pharmacy,Second Mobile Corps Hospital of the People's Armed Police Force,Wuxi Jiangsu 214035,China;Department of Medicine,The First Mobile Corps Hospital of the People's Armed Police Force,Dingzhou Hebei 073000,China;Internal Medicine Department One,The First Mobile Corps Hospital of the People's Armed Police Force,Dingzhou Hebei 073000,China)
出处
《转化医学杂志》
2024年第3期412-416,共5页
Translational Medicine Journal
