2型糖尿病患者应用西格列汀的短期疗效及影响因素

目的 分析2型糖尿病患者应用西格列汀的短期疗效及其影响因素,为临床患者的选择及提高疗效提供依据。 方法 收集2012年9月至2014年6月住院并应用西格列汀的2型糖尿病患者86例病例资料。根据患者空腹C肽水平四分位数分为C肽水平最高组和C肽水平最低组,每组12例。采用多元线性逐步回归分析患者临床资料中影响血糖下降水平的因素。 结果 使用西格列汀后,C肽水平最高组与C肽水平最低组空腹血糖(FBG)下降值、餐后2 h血糖(2h-PBG)下降值及百分数差异无统计学意义(P>0.05)。糖化血红蛋白(HbA1c)是影响FBG下降值及下降百分数的独立因素;用药前2h-PBG水平是影响2h-PBG下降值及其下降百分数的独立因素。患者使用西格列汀后,最大日内血糖波动值较使用前减小且低血糖发生显著减少(P<0.05)。 结论 西格列汀可同时降低患者FBG和2h-PBG,且疗效相当;其对FBG和2h-PBG的疗效不完全依赖于C肽水平;可显著减少血糖波动和低血糖事件的发生。

Clinical studies on type 2 diabetic patients treated with sitagliptin

Objective To analyze the factors that affect the efficacy of sitagliptin in the treatment of type 2 diabetic mellitus(T2DM)patients. Methods Clinical data of 86 T2DM patients who treated with sitagliptin during Sept.2012 and June 2014 were collected. According to the levels of fasting C peptide, the patients were divided into two groups: maximum C peptide group(n=12)and minimum C peptide group(n=12). Multiple line regression analysis was performed to analyze the factors that might affect the efficacy of sitagliptin. Results After administration of sitagliptin, there was no significant difference in the decrease of fasting blood glucose(FBG)and 2 h post prandial blood glucose(2h-PBG)between the maximum and minimum C peptide groups(P>0.05). Multiple line regression analysis showed that HbA1c was an independent factor that affected the decrease of FBG; baseline 2h-PBG level was an independent factor that affected the efficacy of sitagliptin on 2h-PBG. Sitagliptin significantly decreased glucose excursion(P<0.05), and reduced episodes of hypoglycemia. Conclusion Sitagliptin decreases both FBG and 2h-PBG. The efficacy of sitagliptin may not entirely depend on C peptide levels. Sitagliptin significantly decreases blood excursion and hypoglycemia.