二肽基肽酶4抑制剂与长效胰岛素对2型糖尿病患者相关血生化指标影响的比较

目的比较二肽基肽酶4（DPP4）抑制剂与长效胰岛素治疗2型糖尿病患者时相关血生化指标影响。方法对我院2017年1月~2018年7月期间收治的40例2型糖尿病患者，根据治疗方法的不同分为DPP4抑制剂组（沙格列汀）与长效胰岛素组（地特胰岛素或甘精胰岛素），经过3月治疗后，检测每例患者静脉血中血糖、胰岛素水平及胰岛素抵抗系数、血脂情况。结果DPP4组和长效胰岛素组患者的血糖均得到良好控制，两组控制程度差异无统计学意义（F=1.296，P>0.05），而DPP4抑制剂很好的改善了胰岛素的敏感性，DPP4组的胰岛素抵抗系数较长效胰岛素组明显更低，差异具有统计学意义（t=8.11，P<0.05）。DPP4抑制剂相比较长效胰岛素，DPP4抑制剂在甘油三酯、高密度脂蛋白胆固醇的调控上具有优势，甘油三酯的水平更低而高密度脂蛋白胆固醇的水平更高（P<0.05），但在总胆固醇、极低密度脂蛋白胆固醇、低密度脂蛋白胆固醇的水平调节上差异无统计学意义（P>0.05）。结论DPP4抑制剂作为新型2型糖尿病的治疗药物，相比较长效胰岛素能够很好的控制患者的血糖水平，并且增加患者对胰岛素的敏感性，同时也能更好地调节患者的血脂水平。

Effects of DPP4 inhibitor and long-acting insulin therapy on blood biochemical indexes of type 2 diabetes: a comparative study

ObjectiveTo investigate the effects of DPP4 inhibitor and long-acting insulin therapy on blood biochemical indexes of type 2 diabetes.Methods440 cases of type 2 diabetes patients in our department from January 2017 to July 2018 were included and divided into DPP4 group (Saxagliptin) and long-acting insulin group (insulin glargine). All patients received corresponding drugs for 3 months, after which the serum blood glucose, blood lipid, blood insulin and insulin resistance index of each group were detected and recorded.ResultBlood glucose was well controlled in both groups, and there was no significance between the control degrees(F=1.296, P=0.578). However, the insulin resistance index of the DPP4 group was significant lower than that of the long-acting insulin group (t=8.11, P<0.05). Compare to long-acting insulin, DPP4 inhibitor improve insulin sensitivity. The level of triglyceride (TG) of DPP4 group was significantly higher than that of the long-acting insulin group, while the level of highly density lipoprotein cholesterol (HDLC) of DPP4 group was significantly lower than that of its counterpart (P<0.05). indicating that DPP4 inhibitor is better at regulating the level of TG and HDLC. There was no significant difference in the level of total cholesterol (TC), very low density lipoprotein cholesterol (vLDL-C) and low density lipoprotein cholesterol (LDLC) between two groups(P>0.05).ConclusionDPP4 inhibitor, as a new drug used for type 2 diabetes, can effectively regulate the blood glucose and blood lipid and increase the insulin sensibility.