吴心池+唐伟+方铭+高远

doi：10.3969/j.issn.1007-614x.2014.21.7

摘 要 目的：比较西格列汀和阿卡波糖治疗初发2型糖尿病（T2DM）的有效性与耐受性。方法：将60名患者随机分为西格列汀组（30例）和阿卡波糖组（30例），分别口服西格列汀100 mg，1次/日，阿卡波糖50 mg，3次/日。观察治疗前及治疗12周后患者空腹血糖（FPG）、餐后2小时血糖（2hPG）、糖化血红蛋白（HbA1c）及体重指数（BMI）的变化。结果：两组治疗后FPG、2hPG、HbA1c较治疗前均明显下降，差异有统计学意义（P<0.05）。西格列汀组治疗后FPG、HbA1c 降低较阿卡波糖组明显，差异有统计学意义（P<0.05），餐后血糖两组间差异无统计学意义（P>0.05）。两组BMI变化无统计学意义（P>0.05）。阿卡波糖组不良反应比西格列汀组多。结论：西格列汀和阿卡波糖均可有效改善初发2型糖尿病患者的FPG、2hPG及HbA1c。西格列汀降低FPG、HbA1c的作用优于阿卡波糖，对餐后血糖的降低程度相似。

关键词 糖尿病 西格列汀 阿卡波糖

Comparison of the effect of sitagliptin and acarbose on newly-diagnosed type 2 diabetes

Wu Xinchi，Tang Wei，Fang Ming，Gao Yuan

Department of Endocrinology，Jiangyin Hospital Affiliated to Southeast University 214400

Abstract Objective：To explore the efficacy and tolerability of sitagliptin and acarbose on newly-diagnosed type 2 diabetes.Methods：60 cases were randomized divided into the sitagliptin group（30 cases） and the acarbose group（30 cases）.Two groups were treated respectively with sitagliptin 100 mg，1 time/day，and acarbose 50 mg，3 times/day.We observed the changes of fasting blood glucose（FPG），2 hour postprandial blood glucose（2hPG），glycosylated hemoglobin （HbA1c） and body weight before treatment and after 12 weeks of treatment.Results： The FPG，2hPG and HbA1c after treatment obviously decreased，and the difference was statistically significant（P<0.05）.After treatment，the decrease of FPG and HbA1c of the sitagliptin group was more than those of the acarbose group，and the difference was statistically significant（P<0.05）.The difference of 2hPG of the two groups after treatment was not statistically significant（P>0.05）.Weight changes in the two groups were not statistically significant（P>0.05）.Conclusion：Sitagliptin and acarbose can effectively improve the FPG，2hPG and HbA1c of newly-diagnosed type 2 diabetes.The effect of reducing FPG and HbA1c of sitagliptin is better than that of acarbose.The degree is similar to reduce the postprandial blood glucose.

Key words Diabetes；Sitagliptin；Acarbose

西格列汀是FDA首个批准的用于治疗2型糖尿病（T2DM）的DPP-4抑制剂，通过调节胰岛α细胞及β细胞功能改善葡萄糖代谢。研究显示，西格列汀无论单药治疗[1]，还是与二甲双胍联合应用[2]，均能有效降低T2DM患者的HbA1c。阿卡波糖为α-糖苷酶抑制剂，能延缓肠道对葡萄糖的吸收，对降低餐后血糖有明显作用。我们观察了西格列汀和阿卡波糖对初诊断T2DM患者的降糖作用及不良反应，报告如下。

资料与方法

2012年1月-2013年1月收治新诊断T2DM患者60例，符合1999年WHO糖尿病诊断标准，病程1～14个月，未经降糖治疗，肝肾功能正常，近期无糖尿病急性并发症，无心血管病变。其中男34例，女26例，按1：1随机（第1+2n例患者纳入组1，第2+2n例患者纳入组2，n=0、1、2、…29）分配进入西格列汀和阿卡波糖组。……