胰高血糖素样肽1受体激动剂与二肽基肽酶4抑制剂治疗2型糖尿病的效果比较

目的比较胰高血糖素样肽1(GLP-1)受体激动剂与二肽基肽酶4(DPP-4)抑制剂治疗2型糖尿病的效果。方法以2018年2月—2019年2月某医院收治的120例2型糖尿病患者为研究对象进行回顾性研究。60例作为GLP-1受体激动剂组,60例列入DPP-4抑制剂组。GLP-1受体激动剂组给予二甲双胍导入治疗+利拉鲁肽治疗,DPP-4抑制剂组给予二甲双胍导入治疗+西格列汀治疗,比较两组治疗效果。结果GLP-1受体激动剂组患者治疗后空腹血糖(FBG)、餐后2 h血糖(2hPBG)、糖化血红蛋白(HbAlc)、BMI水平分别为:[(5.95±0.86)、(9.33±1.71)、(6.13±0.88)、(24.42±2.13)]mmol/L,低于DPP-4抑制剂组(P<0.05);GLP-1受体激动剂组患者治疗后胰岛素分泌指数(HOMA-B)水平为(60.52±7.12)pmol/L,高于DPP-4抑制剂组(P<0.05);GLP-1受体激动剂组患者治疗后总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)水平低于DPP-4抑制剂组(P<0.05);GLP-1受体激动剂组患者治疗后低密度脂蛋白胆固醇水平高于DPP-4抑制剂组(P<0.05);两组患者用药期间不良反应发生率差异无统计学意义(P>0.05)。结论GLP-1受体激动剂治疗2型糖尿病效果更佳,而DPP-4抑制剂用药更为方便,临床可根据实际情况选择。

Comparison of curative effects between GLP-1 receptor stimulant and DPP-4 inhibitor in treatment of type 2 diabetes mellitus

Objective To compare the curative effects between GLP-1 receptor stimulant and DPP-4 inhibitor in the treatment of type 2 diabetes mellitus. Methods A total of 120 cases of type 2 diabetes mellitus in a hospital from February 2018 to February 2019 were selected as the research objects, and they were divided into a GLP-1 receptor stimulant group (Group A) and a DPP-4 inhibitor group (Group B) with 60 cases in each group. The patients of the Group A were treated by melbine + liraglutide, and the patients of Group B were treated by melbine + sitagliptin. The clinical effects were observed and compared between the two groups. Results The levels of FBG, 2hPBG, HbAlc, and BMI in Group A, were lower than those of Group B (P<0.05). The level of HOMA-B in Group A was higher than that in Group B (60.52±7.12 vs 54.03±6.89) pmol/L (P<0.05). The levels of TC, TG, and HDL-C in Group A were lower than those in Group B (P<0.05). The levels of LDL-C in Group A was higher than that in Group B (P<0.05). There was no significant difference between two groups in the occurrence rate of adverse side effects (21.67% vs 28.33%) (P>0.05). Conclusion GLP-1 receptor stimulant has better curative effect and DPP-4 inhibitor has more convenient in the treatment of type 2 diabetes mellitus. Therefore, the doctors can chose which scheme according to the clinical actual situation.