艾塞那肽治疗2型糖尿病的系统评价

目的:系统评价艾塞那肽治疗2型糖尿病的疗效及安全性。方法:计算机检索Cochrane图书馆、PubMed、Embase、CBM、VIP、CNKI数据库,对纳入的随机对照试验(RCT)进行质量评价,并用RevMan5.0软件进行Meta分析。结果:共纳入5个RCT,Meta分析结果显示:艾塞那肽与胰岛素在改善2型糖尿病患者糖化血红蛋白水平方面差异无统计学意义[MD=0.07,95%CI(-0.02,0.17),P=0.13];在降低空腹血糖方面艾塞那肽组疗效不及胰岛素组[MD=1.21,95%CI(1.15,1.27),P<0.00001];治疗过程中发生低血糖方面的概率2组相当[OR=0.69,95%CI(0.47,1.03),P=0.07]。结论:本系统评价结果初步显示,艾塞那肽可以用于治疗口服降糖药无法有效控制血糖的2型糖尿病患者。远期结果有待进一步研究探讨。

Systematic Review of Exenatide for Type 2 Diabetes

OBJECTIVE：To evaluate the clinical efficacy and safety of exenatide in the treatment of type 2 diabetes. METHODS：Retrieved from Cochrane library,PubMed,Embase,CBM,VIP and CNKI,included randomized controlled trails（RCTs） were evaluated and analyzed using RevMan 5.0 software. RESULTS：Five RCTs were included. The result of Meta-analysis demonstrated that exenatide and insulin achieved similar effect on the improvement of HbA1c in patients with type 2 diabetes [MD=0.07, 95%CI（-0.02,0.17）,P=0.13]. The improvement of fasting glucose in exenatide group inferior to in insulin group [MD=1.21, 95%CI（1.15,1.27）,P0.000 01]. There was no significant difference in rates of hypoglycemia between 2 groups [OR=0.69, 95%CI（0.47,1.03）,P=0.07]. CONCLUSION：Results of systematic review show that exenatide is effective for glycemic control in patients with type 2 diabetes when oral dose of hypoglycemics can’t control the level of blood glucose. Long-term clinical effica- cy should be further studied.