[摘要] 目的 研究格列吡嗪聯(lián)合阿卡波糖治療初診2型糖尿病患者的臨床效果。方法 方便選取100例于2015年2月—2017年1月期間入院治療的2型糖尿病患者，隨機分為觀察組、對照組各50例。對照組患者給予格列吡嗪片，觀察組給予阿卡波糖片聯(lián)合格列吡嗪片，其中格列吡嗪片的劑量在對照組基礎上減半。比較所有患者治療前后FBG、2 hPBG、HbA1c、空腹C肽、肌酐等常規(guī)指標的水平，同時檢測FIns、2 hIns、FGC、2 hGC、FGLP-1以及2 hGLP-1，比較治療過程中低血糖事件以及不良反應發(fā)生情況，評價兩種方案的療效和安全性差異。結果 ①兩組患者治療前各指標比較差異無統(tǒng)計學意義（P>0.05）；治療后，觀察組各項指標均顯著改善，對照組患者的空腹血糖、餐后2 h血糖、HbA1c水平有顯著改善差異有統(tǒng)計學意義（P<0.05）；治療后組間比較，研究組空腹血糖和餐后2 h血糖為（5.57±1.02）、（7.35±1.24）mmol/L，與對照組相比差異無統(tǒng)計學意義（t=0.275、0.356，P>0.05）；觀察組患者的HbA1c水平為（6.21±0.74）%，明顯低于對照組（7.28±0.685），空腹C肽和肌酐分別為（2.19±0.48）ng/mL、（79.85±9.05）μmol/L，顯著高于對照組，組間比較差異有統(tǒng)計學意義（t=4.521、3.642、3.178，P<0.05）。②兩組患者治療前，F(xiàn)Ins、2 hIns、FGC、2 hGC、FGLP-1以及2 hGLP-1等指標組間比較差異無統(tǒng)計學意義（P>0.05）。治療后，兩組患者各指標均有一定改善，觀察組2 hIns、FGLP-1以及2 hGLP-1分別為（36.8±4.0）mIU/mL、（26.5±5.4）pmol/L、（27.10±4.8）pmol/L，明顯高于對照組（33.5±3.4）mIU/mL、（22.4±4.3）pmol/L、（23.5±3.9）pmol/L，F(xiàn)Ins、FGC和2 hGC分別為（6.5±1.3）mIU/mL、（45.8±3.0）pmol/L、（41.8±4.5）pmol/L，顯著低于對照組（7.6±1.5）mIU/mL、（48.5±3.5）pmol/L、（46.8±3.9）pmol/L，差異有統(tǒng)計學意義（P<0.05）。③觀察組患者不良反應發(fā)生率為8.0%，對照組不良反應發(fā)生率為12.0%，其中2例患者出現(xiàn)低血糖反應，組間比較，差異有統(tǒng)計學意義（P<0.05）。結論 格列吡嗪聯(lián)合阿卡波糖用于初診2型糖尿病患者的治療，不僅空腹血糖和餐后2 h血糖水平控制效果更好，且HbA1c水平也相對降低，低血糖事件減少，不良反應發(fā)生率降低，值得臨床推廣應用。
　　[關鍵詞] 格列吡嗪；阿卡波糖；2型糖尿��；血糖
　　[中圖分類號] R5 [文獻標識碼] A [文章編號] 1674-0742（2018）01（c）-0018-04
　　[Abstract] Objective This paper tries to study the clinical effect of glipizide combined with acarbose in the treatment of newly diagnosed patients with type 2 diabetes. Methods 100 patients with type 2 diabetes admitted to the hospital during February 2015 and January 2017 were conveient selected randomly divided into two groups： the observation group and the control group， with 50 cases for each group. The control group was treated with Glipizide tablets， and the observation group was treated with the Acarbose tablet joint Glipizide tablets， and the dose of Glipizide tablets was halved on the basis of the control group. To record the level of FBG， 2 hPBG， HbA1c， fasting C peptide， creatinine before and after treatment， at the same time， to test FIns， 2 hIns， FGC， 2 hGC， FGLP-1 and 2 hGLP-1， and hypoglycemic events and adverse events during treatment. Results ①Before treatment， there were no significant differences in each index of the two groups of patients（P>0.05）；after treatment， the indicators in the observation group were significantly improved. In the control group， FBG， 2 hBG and HbA1c levels were improved significantly（P<0.05）； After treatment， the study group of FBG and 2 hBG was（5.57±1.02），（7.35±1.24）mmol/L， with no significant difference compared with the control group（t=0.275， 0.356，P>0.05）； HbA1c for the observation group was（6.21±0.74）%， which was significantly lower than the control group of（7.28±0.68）%， fasting C peptide and serum creatinine were relatively （2.19±0.48）ng/mL and（79.85±9.05）μmol/L， significantly higher than the control group， comparison between groups（t=4.521， 3.642，3.178，P<0.05）. ②Before treatment， there were no significant differences between groups of FIns， 2 hIns， FGC， 2 hGC， FGLP-1 and 2 hGLP-1（P>0.05）. After treatment， the indexes of two groups were improved， compared between the two groups， 2 hIns， FGLP-1 and 2 hGLP-1 for the observation group were relatively（36.8±4.0）mIU/mL，（26.5±5.4）pmol/L，（27.10±4.8）pmol/L， significantly higher than those in the control group of（33.5±3.4）mIU/mL，（22.4±4.3）pmol/L，（23.5±3.9）pmol/L， FIns， FGC and 2 hGC were（6.5±1.3）mIU/mL，（45.8±3.0）pmol/L，（41.8±4.5）pmol/L， significantly lower than the control group of（7.6±1.5）mIU/mL， （48.5±3.5）pmol/L，（46.8±3.9）pmol/L， significantly different（P<0.05）. ③The incidence of adverse reactions was 8.0% in the observation group and 12.0% in the control group， and hypoglycemia occurred in 2 patients. The difference between the two groups was significant（P<0.05）. Conclusion In the treatment of newly diagnosed patients with type 2 diabetes， glipizide combined with acarbose can not only control the FBG and 2 hBG， and the HbA1c level is relatively reduced， hypoglycemia events decrease， the incidence of adverse reactions decreased， it is worthy of clinical application.

相關熱詞搜索：初診 應用于 糖尿病 阿卡 臨床